Xibalba Technological Solutions, LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

XIBALBA TECHNOLOGICAL SOLUTIONS, LLC

Practice address

1409 Sheridan Rd
Kenosha, WI 53140-4443

Phone

(872) 356-1650

NPI assigned

Jun 2, 2017

Organization subpart

No

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

Authorized official

Name

Jacob Vickers

Title

Owner

Phone

(872) 356-1650

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1496361600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1760910731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1409 SHERIDAN RD",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531404443",
            "telephone_number": "872-356-1650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1409 SHERIDAN RD",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531404443",
            "telephone_number": "872-356-1650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "XIBALBA TECHNOLOGICAL SOLUTIONS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-02",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "VICKERS",
        "authorized_official_first_name": "JACOB",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "872-356-1650"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heather M Wulterkens, AU.D.
• Stephanie Rose Wynn, NP
• Andrew Scott Freeman Wyosnick, R.N.
• Glenn R Wysocki, DC
• Lori Ella Wysong, CPNP-PC
• Xa X Xiong, MD
• Nevine Ramsis Yacoub, M.D.
• Nana Boahene Kwabena Yeboah, D.D.S.
• Bryton Alan Yepsen, DC
• Maryana Yevtukh, DO

• Durable Medical Equipment & Medical Supplies in Kenosha, WI
• Providers in Kenosha, WI by specialty
• Durable Medical Equipment & Medical Supplies in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.