Active NPI
Sally G Hunt, M.D.
- Pediatrics Physician
- Mequon, WI
National Provider Identifier
1972598134
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 23354
- Practice address
- 10532 N Port Washington Rd
Suite 1a
Mequon, WI 53092-5563 - Phone
- (262) 240-9744
- Fax
- (262) 240-9745
- NPI assigned
- Sep 14, 2005
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 23354 | WI | Primary |
Addresses
Primary practice location
10532 N Port Washington Rd
Suite 1a
Mequon, WI 53092-5563
Mailing address
10532 N Port Washington Rd
Suite 1a
Mequon, WI 53092-5563
Phone (262) 240-9744
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 30448300 | 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 |
|---|---|---|---|
| 23354 | WI | MD | Cardiovascular Disease Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1126656000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1257206400000",
"number": "1972598134",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10532 N PORT WASHINGTON RD",
"address_2": "SUITE 1A",
"city": "MEQUON",
"state": "WI",
"postal_code": "530925563",
"telephone_number": "262-240-9744",
"fax_number": "262-240-9745"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10532 N PORT WASHINGTON RD",
"address_2": "SUITE 1A",
"city": "MEQUON",
"state": "WI",
"postal_code": "530925563",
"telephone_number": "262-240-9744",
"fax_number": "262-240-9745"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HUNT",
"first_name": "SALLY",
"middle_name": "G",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-09-14",
"last_updated": "2009-11-03",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "WI",
"license": "23354",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "30448300",
"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 Nov 3, 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.