Active NPI
Angela M Ventura
- Contractor
- Kenosha, WI
National Provider Identifier
1902134141
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Contractor
- License
- 746-24
- Practice address
- 4931 68TH St
Kenosha, WI 53142-1616 - Phone
- (262) 654-4757
- NPI assigned
- Nov 30, 2009
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Contractor | 171W00000X | 746-24 | WI | Primary |
Addresses
Primary practice location
4931 68TH St
Kenosha, WI 53142-1616
Mailing address
4931 68TH St
Kenosha, WI 53142-1616
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 40008600 | 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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 746-24 | WI | MD | Contractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1259539200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1259539200000",
"number": "1902134141",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4931 68TH ST",
"city": "KENOSHA",
"state": "WI",
"postal_code": "531421616"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4931 68TH ST",
"city": "KENOSHA",
"state": "WI",
"postal_code": "531421616",
"telephone_number": "262-654-4757"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VENTURA",
"first_name": "ANGELA",
"middle_name": "M",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-11-30",
"last_updated": "2009-11-30",
"status": "A"
},
"taxonomies": [
{
"code": "171W00000X",
"taxonomy_group": "",
"desc": "Contractor",
"state": "WI",
"license": "746-24",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "40008600",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Kenosha, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.