Individual provider Active NPI

Kristen Drewry

  • Driver
  • Fond Du Lac, WI
National Provider Identifier
1962614438
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DriverTaxonomy code 172A00000X
License
D6605127394304 Issued in WI
Practice address
557 W Scott St
Fond Du Lac, WI 54937-2125
Phone
(920) 960-3706
Fax
(920) 322-0002
NPI assigned
May 4, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Driver 172A00000X D6605127394304 WI Primary

Addresses

Primary practice location

557 W Scott St
Fond Du Lac, WI 54937-2125

Mailing address

557 W Scott St
Fond Du Lac, WI 54937-2125
Phone (920) 960-3706

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

LicenseStateTypeSpecialty
D6605127394304WIMDDriver

NPI Registry JSON

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

{
    "created_epoch": "1178236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1962614438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "557 W SCOTT ST",
            "city": "FOND DU LAC",
            "state": "WI",
            "postal_code": "549372125",
            "telephone_number": "920-960-3706",
            "fax_number": "920-322-0002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "557 W SCOTT ST",
            "city": "FOND DU LAC",
            "state": "WI",
            "postal_code": "549372125",
            "telephone_number": "920-960-3706",
            "fax_number": "920-322-0002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DREWRY",
        "first_name": "KRISTEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172A00000X",
            "taxonomy_group": "",
            "desc": "Driver",
            "state": "WI",
            "license": "D6605127394304",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fond Du Lac, 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.

Verify at the official NPI Registry.