Organization Active NPI

Thomas J Kalinosky DO

  • Family Medicine Physician
  • Beaver Dam, WI
National Provider Identifier
1992876734
Registry record updated Dec 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
24188 Issued in WI
Legal business name
THOMAS J KALINOSKY DO
Practice address
215 Corporate Dr
Suite G
Beaver Dam, WI 53916-3123
Phone
(920) 887-7692
Fax
(920) 887-7694
NPI assigned
Nov 13, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2013

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

Authorized official

Name
Dr. Thomas J Kalinosky, DO
Title
Owner DO
Phone
(920) 887-7692

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X 24188 WI Primary

Addresses

Primary practice location

215 Corporate Dr
Suite G
Beaver Dam, WI 53916-3123

Mailing address

215 Corporate Dr
Suite G
Beaver Dam, WI 53916-3123
Phone (920) 887-7692

Other identifiers 2

IdentifierTypeStateIssuer
43959900MedicaidWI
30016200MedicaidWI

National Provider Directory

National Provider Directory

Locations

215 Corporate Dr
Beaver Dam, WI 53916
Phone (920) 887-7692

148 Warren St
Ste B
Beaver Dam, WI 53916
Phone (920) 887-7692

215 Corporate Dr
Ste G
Beaver Dam, WI 53916
Phone (920) 887-7692

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1387238400000",
    "number": "1992876734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 CORPORATE DR",
            "address_2": "SUITE G",
            "city": "BEAVER DAM",
            "state": "WI",
            "postal_code": "539163123",
            "telephone_number": "920-887-7692",
            "fax_number": "920-887-7694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 CORPORATE DR",
            "address_2": "SUITE G",
            "city": "BEAVER DAM",
            "state": "WI",
            "postal_code": "539163123",
            "telephone_number": "920-887-7692",
            "fax_number": "920-887-7694"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THOMAS J KALINOSKY DO",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-13",
        "last_updated": "2013-12-17",
        "status": "A",
        "authorized_official_last_name": "KALINOSKY",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER DO",
        "authorized_official_telephone_number": "920-887-7692",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "24188",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "43959900",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30016200",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaver Dam, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2013; 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.