Individual provider Active NPI

Brian J Nelson

  • Hearing Instrument Specialist
  • Burlington, WI
National Provider Identifier
1740653344
Registry record updated Nov 4, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hearing Instrument SpecialistTaxonomy code 237700000X
License
1383 Issued in WI
Practice address
1092 Milwaukee Ave
Burlington, WI 53105-1362
Phone
(262) 757-0200
Fax
(262) 757-0201
NPI assigned
Nov 4, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hearing Instrument Specialist 237700000X 1383 WI Primary

Addresses

Primary practice location

1092 Milwaukee Ave
Burlington, WI 53105-1362

Mailing address

5200 Washington Ave
Suite 102
Racine, WI 53406-4238
Phone (262) 637-5668

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

LicenseStateTypeSpecialty
1383WIMDHearing Instrument Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Southeast Wisconsin Hearing, LLC 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.

NPI Registry JSON

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

{
    "created_epoch": "1446595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446595200000",
    "number": "1740653344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 WASHINGTON AVE",
            "address_2": "SUITE 102",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "534064238",
            "telephone_number": "262-637-5668",
            "fax_number": "262-637-5009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1092 MILWAUKEE AVE",
            "city": "BURLINGTON",
            "state": "WI",
            "postal_code": "531051362",
            "telephone_number": "262-757-0200",
            "fax_number": "262-757-0201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "BRIAN",
        "middle_name": "J",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-11-04",
        "last_updated": "2015-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "237700000X",
            "taxonomy_group": "",
            "desc": "Hearing Instrument Specialist",
            "state": "WI",
            "license": "1383",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burlington, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 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.

Verify at the official NPI Registry.