Active NPI
Wayne E. Myhre, D.D.S.
- Dentist
- Hillsboro, WI
National Provider Identifier
1821183393
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 2391
- Practice address
- 300 Water Avenue
Hillsboro, WI 54634-0425 - Phone
- (608) 489-2727
- Fax
- (608) 489-4356
- NPI assigned
- Oct 3, 2006
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Dentist | 122300000X | 2391 | WI | Primary |
Addresses
Primary practice location
300 Water Avenue
Hillsboro, WI 54634-0425
Mailing address
300 Water Avenue
P. O. Box425
Hillsboro, WI 54634-0425
Phone (608) 489-2727
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160203000844 | WI | Order and Referring Only - Dentist | 9537463013 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2391 | WI | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159833600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1821183393",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "300 WATER AVENUE",
"address_2": "P. O. BOX425",
"city": "HILLSBORO",
"state": "WI",
"postal_code": "546340425",
"telephone_number": "608-489-2727",
"fax_number": "608-489-4356"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 WATER AVENUE",
"city": "HILLSBORO",
"state": "WI",
"postal_code": "546340425",
"telephone_number": "608-489-2727",
"fax_number": "608-489-4356"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MYHRE",
"first_name": "WAYNE",
"middle_name": "E.",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-03",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "WI",
"license": "2391",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hillsboro, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.