John C Matteucci Jr MD SC

Primary specialty

Urology PhysicianTaxonomy code 208800000X

Legal business name

JOHN C MATTEUCCI JR MD SC

Practice address

6127 Green Bay Road
Suite 600
Kenosha, WI 53142-2973

Phone

(262) 653-9221

Fax

(262) 653-9229

NPI assigned

Aug 31, 2007

Organization subpart

No

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

Authorized official

Name

John C Matteucci Jr., MD

Title

President

Phone

(262) 653-9221

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1188518400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1188518400000",
    "number": "1801080973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6127 GREEN BAY ROAD",
            "address_2": "SUITE 600",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531422973",
            "telephone_number": "262-653-9221",
            "fax_number": "262-653-9229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6127 GREEN BAY ROAD",
            "address_2": "SUITE 600",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531422973",
            "telephone_number": "262-653-9221",
            "fax_number": "262-653-9229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN C MATTEUCCI JR MD SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-31",
        "last_updated": "2007-08-31",
        "status": "A",
        "authorized_official_last_name": "MATTEUCCI",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "262-653-9221",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Urology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristina Lynn Jerry
• Sara N Jettawi, LPC
• Patricia L. Jindrich, LPC
• Amber Jirschele, NP
• Debra Johansen, PHD
• John P Rende DDS SC
• Alayna Johnson, OTR
• Amiya Jada Johnson, APRN
• Colleen Maroney Johnson, M.D.
• Ebba M Johnson, PT

• Urology Physician in Kenosha, WI
• Providers in Kenosha, WI by specialty
• Urology Physician in Wisconsin

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

Verify at the official NPI Registry.