Active NPI
William Joseph Kellner, MD
- Pediatrics Physician
- De Pere, WI
National Provider Identifier
1841274693
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 23105
- Practice address
- 555 Redbird Cir
De Pere, WI 54115-7977 - Phone
- (920) 338-6820
- NPI assigned
- Dec 5, 2005
- Last updated
- Mar 14, 2014
- 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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 23105 | WI | Primary |
Addresses
Primary practice location
555 Redbird Cir
De Pere, WI 54115-7977
Mailing address
555 Redbird Cir
De Pere, WI 54115-7977
Phone (920) 338-6820
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 23105 | Other | WI | LICENSE |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1133740800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1394755200000",
"number": "1841274693",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "555 REDBIRD CIR",
"city": "DE PERE",
"state": "WI",
"postal_code": "541157977",
"telephone_number": "920-338-6820"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "555 REDBIRD CIR",
"city": "DE PERE",
"state": "WI",
"postal_code": "541157977",
"telephone_number": "920-338-6820"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KELLNER",
"first_name": "WILLIAM",
"middle_name": "JOSEPH",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-12-05",
"last_updated": "2014-03-14",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "WI",
"license": "23105",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "23105",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}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 14, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.