NPIMap

Organization Active NPI

Mercy Family Practice SC

  • Internal Medicine Physician
  • De Pere, WI
National Provider Identifier
1831256866
Registry record updated Mar 4, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
MERCY FAMILY PRACTICE SC
Practice address
1500 Heritage Rd, Suite a
De Pere, WI 54115-4017
Phone
(920) 347-1990
Fax
(920) 347-1991
NPI assigned
Jan 2, 2007
Last updated
Mar 4, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2015

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

Authorized official

Name
Kevin P Rosteing, MD MSMINPI 1811121023
Title
Business Manager
Phone
(920) 347-1990

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X NU Primary

Addresses

Primary practice location

1500 Heritage Rd, Suite a
De Pere, WI 54115-4017

Mailing address

1500 Heritage Rd, Suite a
De Pere, WI 54115-4017
Phone (920) 347-1990

Other identifiers 2

IdentifierTypeStateIssuer
000007335OtherWIMEDICARE ID
34129300MedicaidWI

Other names 1

  • Mercy Family Practice Service Corporation Other name

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1167696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1425427200000",
    "number": "1831256866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 HERITAGE RD, SUITE A",
            "city": "DE PERE",
            "state": "WI",
            "postal_code": "541154017",
            "telephone_number": "920-347-1990",
            "fax_number": "920-347-1991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 HERITAGE RD, SUITE A",
            "city": "DE PERE",
            "state": "WI",
            "postal_code": "541154017",
            "telephone_number": "920-347-1990",
            "fax_number": "920-347-1991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERCY FAMILY PRACTICE SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-02",
        "last_updated": "2015-03-04",
        "status": "A",
        "authorized_official_last_name": "ROSTEING",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "920-347-1990",
        "authorized_official_credential": "MD MSMI"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID",
            "identifier": "000007335",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "34129300",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mercy Family Practice Service Corporation",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in De Pere, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2015; 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.