Active NPI
Lake Country Emergency Physicians
- Emergency Medicine Physician
- Oconomowoc, WI
National Provider Identifier
1720060585
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- Legal business name
- LAKE COUNTRY EMERGENCY PHYSICIANS
- Practice address
- 791 E Summit Ave
Oconomowoc, WI 53066-3844 - Phone
- (262) 569-0251
- Fax
- (262) 569-0342
- NPI assigned
- Nov 17, 2005
- Last updated
- Jul 26, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Timothy Hill, M.D.
- Title
- President
- Phone
- (262) 569-0251
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | Primary |
Addresses
Primary practice location
791 E Summit Ave
Oconomowoc, WI 53066-3844
Mailing address
6400 Industrial Loop
Greendale, WI 53129-2452
Phone (414) 423-4100
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI
Enrollment records 1
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 70
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1132185600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1185408000000",
"number": "1720060585",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6400 INDUSTRIAL LOOP",
"city": "GREENDALE",
"state": "WI",
"postal_code": "531292452",
"telephone_number": "414-423-4100",
"fax_number": "414-423-4134"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "791 E SUMMIT AVE",
"city": "OCONOMOWOC",
"state": "WI",
"postal_code": "530663844",
"telephone_number": "262-569-0251",
"fax_number": "262-569-0342"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LAKE COUNTRY EMERGENCY PHYSICIANS",
"organizational_subpart": "NO",
"enumeration_date": "2005-11-17",
"last_updated": "2007-07-26",
"status": "A",
"authorized_official_last_name": "HILL",
"authorized_official_first_name": "TIMOTHY",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "262-569-0251",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Emergency Medicine",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Oconomowoc, WI
- Gerard L. Kupperman, PH.D.
- Lake Area Free Clinic
- Lake Country Birth LLC
- Lake Country Classical Academy, Inc.
- Lake Country Dentistry, L.L.C.
- Lake Country Endoscopy Center, LLC
- Lake Country Pain Treatment
- Lake Country Pediatrics SC (Lake Country Physicians)
- Lake Country Pharmacy
- Lake Country Private Medical, S.C.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.