Active NPI
Scott Behrens, MD
- Anesthesiology Physician
- Neenah, WI
National Provider Identifier
1760479737
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- 22621-020
- Practice address
- 130 2ND St
Ste A107
Neenah, WI 54956-2883 - Phone
- (920) 729-3332
- NPI assigned
- Oct 4, 2005
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 22621-020 | WI | Primary |
Addresses
Primary practice location
130 2ND St
Ste A107
Neenah, WI 54956-2883
Mailing address
804 Scott Nixon Memorial Dr
Augusta, GA 30907-2464
Phone (920) 729-3332
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 30376300 | Medicaid | WI |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 22621-020 | WI | MD | Anesthesiology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1128384000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1193788800000",
"number": "1760479737",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "804 SCOTT NIXON MEMORIAL DR",
"city": "AUGUSTA",
"state": "GA",
"postal_code": "309072464",
"telephone_number": "920-729-3332"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "130 2ND ST",
"address_2": "STE A107",
"city": "NEENAH",
"state": "WI",
"postal_code": "549562883",
"telephone_number": "920-729-3332"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BEHRENS",
"first_name": "SCOTT",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-10-04",
"last_updated": "2007-10-31",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "WI",
"license": "22621-020",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "30376300",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Neenah, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 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.