Jerold J Beerends, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

20959 Issued in WI

Practice address

205 Valley Ave
West Bend, WI 53095-5312

Phone

(262) 338-1123

Fax

(262) 338-7684

NPI assigned

Aug 5, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1303257600000",
    "number": "1871502500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3003 W GOOD HOPE RD",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532092042",
            "telephone_number": "414-352-3100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 VALLEY AVE",
            "city": "WEST BEND",
            "state": "WI",
            "postal_code": "530955312",
            "telephone_number": "262-338-1123",
            "fax_number": "262-338-7684"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEERENDS",
        "first_name": "JEROLD",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-05",
        "last_updated": "2011-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WI",
            "license": "20959",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30104200",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mary Grace Baumgartner, LCSW
• Nickole Becker, LPC-IT
• B J Beckerrn, RN
• Constance Bednar, OTR
• Dawn M. Bednarek, P.T.A.
• Rachel Beimborn, R.N.
• Kelly Marie Bell, LCSW
• John S Belland, DC
• Alison Blegen Below, D.M.D.
• Terrance J Benda, DPM

• All providers in West Bend, WI
• Pediatrics Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2011; 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.