Southern Door County School District

Primary specialty

Local Education Agency (LEA)Taxonomy code 251300000X

License

44201500 Issued in WI

Legal business name

SOUTHERN DOOR COUNTY SCHOOL DISTRICT

Practice address

2073 County Trunk DK
Brussels, WI 54204

Phone

(920) 825-7311

Fax

(920) 825-7311

NPI assigned

Nov 23, 2007

Organization subpart

No

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

Authorized official

Name

Joseph Innis

Title

District Administrator

Phone

(920) 825-7311

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1195776000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1195776000000",
    "number": "1730360306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2073 COUNTY TRUNK DK",
            "city": "BRUSSELS",
            "state": "WI",
            "postal_code": "54204",
            "telephone_number": "920-825-7311",
            "fax_number": "920-825-7311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2073 COUNTY TRUNK DK",
            "city": "BRUSSELS",
            "state": "WI",
            "postal_code": "54204",
            "telephone_number": "920-825-7311",
            "fax_number": "920-825-7311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN DOOR COUNTY SCHOOL DISTRICT",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-23",
        "last_updated": "2007-11-23",
        "status": "A",
        "authorized_official_last_name": "INNIS",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_title_or_position": "DISTRICT ADMINISTRATOR",
        "authorized_official_telephone_number": "920-825-7311"
    },
    "taxonomies": [
        {
            "code": "251300000X",
            "taxonomy_group": "",
            "desc": "Local Education Agency (LEA)",
            "state": "WI",
            "license": "44201500",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "44201500",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Clare Destree, L.P.N
• Christine Hyland Hayes, R.N.
• Tyler Nellis, CPED4584
• Rebecca Schmelzer, LMT
• Debra Schmidt
• Tru-Way Transport, LLC

• Local Education Agency (LEA) in Brussels, WI
• Providers in Brussels, WI by specialty
• Local Education Agency (LEA) in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.