Active NPI
James A Puerner, MD
- Anatomic Pathology & Clinical Pathology Physician
- Mequon, WI
National Provider Identifier
1881785657
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anatomic Pathology & Clinical Pathology Physician
- License
- 38934
- Practice address
- 13111 N Port Washington Road
Mequon, WI 53097 - Phone
- (262) 243-7423
- Fax
- (262) 243-7407
- NPI assigned
- Sep 27, 2006
- 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 |
|---|---|---|---|---|
| Anatomic Pathology & Clinical Pathology Physician | 207ZP0102X | 38934 | WI | Primary |
Addresses
Primary practice location
13111 N Port Washington Road
Mequon, WI 53097
Mailing address
4874 N Woodburn Street
Whitefish Bay, WI 53217
Phone (414) 906-8056
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 32328100 | Medicaid | WI |
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)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 38934 | WI | MD | Anatomic Pathology & Clinical Pathology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159315200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1881785657",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4874 N WOODBURN STREET",
"city": "WHITEFISH BAY",
"state": "WI",
"postal_code": "53217",
"telephone_number": "414-906-8056"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13111 N PORT WASHINGTON ROAD",
"city": "MEQUON",
"state": "WI",
"postal_code": "53097",
"telephone_number": "262-243-7423",
"fax_number": "262-243-7407"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PUERNER",
"first_name": "JAMES",
"middle_name": "A",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-27",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207ZP0102X",
"taxonomy_group": "",
"desc": "Pathology, Anatomic Pathology & Clinical Pathology",
"state": "WI",
"license": "38934",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "32328100",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Mequon, 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.