Active NPI
Laura Erbentraut
- Driver
- Kenosha, WI
National Provider Identifier
1710378237
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Driver
- License
- WI-560790
- Practice address
- 3410 18TH St
Kenosha, WI 53144-1402 - Phone
- (262) 671-1759
- Fax
- (262) 347-3603
- NPI assigned
- Feb 6, 2015
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Driver | 172A00000X | WI-560790 | WI | Primary |
Addresses
Primary practice location
3410 18TH St
Kenosha, WI 53144-1402
Mailing address
3410 18TH St
Kenosha, WI 53144-1402
Phone (262) 671-1759
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| WI-560790 | WI | MD | Driver |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Safe Transport Inc. | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Non-emergency Medical Transport (VAN)
- Kenosha, WI
- NPI 1720479447
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1423180800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1423180800000",
"number": "1710378237",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3410 18TH ST",
"city": "KENOSHA",
"state": "WI",
"postal_code": "531441402",
"telephone_number": "262-671-1759",
"fax_number": "262-347-3603"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3410 18TH ST",
"city": "KENOSHA",
"state": "WI",
"postal_code": "531441402",
"telephone_number": "262-671-1759",
"fax_number": "262-347-3603"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ERBENTRAUT",
"first_name": "LAURA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-02-06",
"last_updated": "2015-02-06",
"status": "A"
},
"taxonomies": [
{
"code": "172A00000X",
"taxonomy_group": "",
"desc": "Driver",
"state": "WI",
"license": "WI-560790",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kenosha, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.