1386722478 NPI number — NORTH WINNESHIEK COMMUNITY SCHOOL DISTRICT

Table of content: KATHY RITTER GONZALEZ O.D. (NPI 1174551543)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1386722478 NPI number — NORTH WINNESHIEK COMMUNITY SCHOOL DISTRICT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NORTH WINNESHIEK COMMUNITY SCHOOL DISTRICT
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1386722478
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3495 N WINN RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DECORAH
Provider Business Mailing Address State Name:
IA
Provider Business Mailing Address Postal Code:
52101-7761
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
563-735-5411
Provider Business Mailing Address Fax Number:
563-735-5430

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3495 N WINN RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DECORAH
Provider Business Practice Location Address State Name:
IA
Provider Business Practice Location Address Postal Code:
52101-7761
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
563-735-5411
Provider Business Practice Location Address Fax Number:
563-735-5430
Provider Enumeration Date:
11/02/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
DUGGER
Authorized Official First Name:
TIMOTHY
Authorized Official Middle Name:
GERALD
Authorized Official Title or Position:
SUPERINTENDENT/PRINCIPAL
Authorized Official Telephone Number:
563-735-5411

Provider Taxonomy Codes

  • Taxonomy code: 251300000X , registered in the state of IA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0483099 , issued by the state of ( IA ) . This identifiers is of the category "MEDICAID".