Organization Active NPI

Plymouth Joint School District

  • Local Education Agency (LEA)
  • Plymouth, WI
National Provider Identifier
1710166277
Registry record updated Oct 31, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Local Education Agency (LEA)Taxonomy code 251300000X
Legal business name
PLYMOUTH JOINT SCHOOL DISTRICT
Practice address
125 S Highland Ave
Plymouth, WI 53073-2566
Phone
(920) 892-5022
Fax
(920) 892-5078
NPI assigned
Oct 31, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Anne Gamoke
Title
Pupil Services Director
Phone
(920) 892-5022

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Local Education Agency (LEA) 251300000X Primary

Addresses

Primary practice location

125 S Highland Ave
Plymouth, WI 53073-2566

Mailing address

125 S Highland Ave
Plymouth, WI 53073-2566
Phone (920) 892-5022

Other identifiers 1

IdentifierTypeStateIssuer
44218400MedicaidWI

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
52D2226809Plymouth School District125 Highland Ave, Plymouth, WI 53073Certificate of waiverJun 3, 2027

National Provider Directory

National Provider Directory

Locations

125 S Highland Ave
Plymouth, WI 53073
Phone (920) 892-2661

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1193788800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193788800000",
    "number": "1710166277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 S HIGHLAND AVE",
            "city": "PLYMOUTH",
            "state": "WI",
            "postal_code": "530732566",
            "telephone_number": "920-892-5022",
            "fax_number": "920-892-5078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 S HIGHLAND AVE",
            "city": "PLYMOUTH",
            "state": "WI",
            "postal_code": "530732566",
            "telephone_number": "920-892-5022",
            "fax_number": "920-892-5078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PLYMOUTH JOINT SCHOOL DISTRICT",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-31",
        "last_updated": "2007-10-31",
        "status": "A",
        "authorized_official_last_name": "GAMOKE",
        "authorized_official_first_name": "ANNE",
        "authorized_official_title_or_position": "PUPIL SERVICES DIRECTOR",
        "authorized_official_telephone_number": "920-892-5022"
    },
    "taxonomies": [
        {
            "code": "251300000X",
            "taxonomy_group": "",
            "desc": "Local Education Agency (LEA)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "44218400",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.