Individual provider Active NPI

Susan Elizabeth Joseph, MD

  • Family Medicine Physician
  • Sheboygan Falls, WI
National Provider Identifier
1750357141
Registry record updated Aug 2, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
31334 Issued in WI
Practice address
W2850 State Highway 28
Sheboygan Falls, WI 53085
Phone
(920) 467-1800
Fax
(920) 467-1900
NPI assigned
Feb 24, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 2, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 31334 WI Primary

Addresses

Primary practice location

W2850 State Highway 28
Sheboygan Falls, WI 53085

Mailing address

W2850 State Highway 28
Sheboygan Falls, WI 53085-2702
Phone (920) 467-1800

Other identifiers 1

IdentifierTypeStateIssuer
31626800MedicaidWI

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
31334WIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mueller Therapy, Inc. PastSince Mar 1, 2019 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": "1140739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533168000000",
    "number": "1750357141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "W2850 STATE HIGHWAY 28",
            "city": "SHEBOYGAN FALLS",
            "state": "WI",
            "postal_code": "530852702",
            "telephone_number": "920-467-1800",
            "fax_number": "920-467-1900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "W2850 STATE HIGHWAY 28",
            "city": "SHEBOYGAN FALLS",
            "state": "WI",
            "postal_code": "53085",
            "telephone_number": "920-467-1800",
            "fax_number": "920-467-1900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOSEPH",
        "first_name": "SUSAN",
        "middle_name": "ELIZABETH",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-02-24",
        "last_updated": "2018-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "31334",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "31626800",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sheboygan Falls, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2018; 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.