Michael H Hetzner, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

27988 Issued in WI

Practice address

632 Fremont St
Kiel, WI 53042-1321

Phone

(920) 894-3322

NPI assigned

Sep 12, 2005

Last updated

Sep 2, 2008By the provider in NPPES

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

Enrolled in WI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Ascension Calumet Hospital, Inc

  dba Ascension Calumet Hospital

  • Critical Access Hospital
  • Chilton, WI
  • NPI 1376541748
  Medicare reassignment NPD

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

{
    "created_epoch": "1126483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1220313600000",
    "number": "1942295464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "632 FREMONT ST",
            "city": "KIEL",
            "state": "WI",
            "postal_code": "530421321",
            "telephone_number": "920-894-3322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "632 FREMONT ST",
            "city": "KIEL",
            "state": "WI",
            "postal_code": "530421321",
            "telephone_number": "920-894-3322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HETZNER",
        "first_name": "MICHAEL",
        "middle_name": "H",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-12",
        "last_updated": "2008-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "27988",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30040900",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Courtney A Hansen, APNP FNP-BC
• Lisa Anne Held, OTR/CCM
• Rachel Ann Henkel, RN
• Barbara K Henry, LCSW
• Christine Robin Herziger, P.T.
• Jessica Hoefler
• Kristen D Holzwart, MSN, APNP, FNP-C
• Jessica Hoppa, RN
• Andrew James Jacobchick, BA, SAC-IT
• Eman Wja Jammali

• Family Medicine Physician in Kiel, WI
• Providers in Kiel, WI by specialty
• Family Medicine Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.