Active NPI
Gregory Mathew Kolar, MS ED
- Counselor
- Manitowoc, WI
National Provider Identifier
1710070305
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- Practice address
- 115 E Waldo Blvd
Manitowoc, WI 54220 - Phone
- (920) 682-6087
- NPI assigned
- Oct 2, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | Primary |
Addresses
Primary practice location
115 E Waldo Blvd
Manitowoc, WI 54220
Mailing address
4555 W Schroeder Drive
Suite 170
Milwaukee, WI 53223
Phone (414) 365-3210
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 40969400 | Medicaid | WI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159747200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1206316800000",
"number": "1710070305",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4555 W SCHROEDER DRIVE",
"address_2": "SUITE 170",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "53223",
"telephone_number": "414-365-3210",
"fax_number": "414-365-3225"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "115 E WALDO BLVD",
"city": "MANITOWOC",
"state": "WI",
"postal_code": "54220",
"telephone_number": "920-682-6087"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOLAR",
"first_name": "GREGORY",
"middle_name": "MATHEW",
"credential": "MS ED",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-02",
"last_updated": "2008-03-24",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "40969400",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Manitowoc, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.