Wellfleet Medical LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

WELLFLEET MEDICAL LLC

Practice address

1124 Professional Dr Ste 500
Dodgeville, WI 53533-1176

Phone

(608) 341-6601

NPI assigned

Apr 4, 2024

Organization subpart

No

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

Authorized official

Name

Kenneth Valyo, DO

Title

Owner

Phone

(608) 341-6601

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1712188800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712188800000",
    "number": "1881446474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1124 PROFESSIONAL DR STE 500",
            "city": "DODGEVILLE",
            "state": "WI",
            "postal_code": "535331176",
            "telephone_number": "608-341-6601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1124 PROFESSIONAL DR STE 500",
            "city": "DODGEVILLE",
            "state": "WI",
            "postal_code": "535331176",
            "telephone_number": "608-341-6601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLFLEET MEDICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-04",
        "last_updated": "2024-04-04",
        "certification_date": "2024-04-04",
        "status": "A",
        "authorized_official_last_name": "VALYO",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "608-341-6601",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinic/Center in Dodgeville, WI
• Providers in Dodgeville, WI by specialty
• Clinic/Center in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2024; 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.