DR. CULLEN TIMOTHY KEHOE DO NPI 1013166925

NPI Information

  • NPI: 1013166925
  • Provider Name: DR. CULLEN TIMOTHY KEHOE, DO
  • Classification: Emergency Medicine - 207P00000X
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: N2950 STATE ROAD 67
    LAKE GENEVA, WI
    ZIP 53147
  • Phone: (262) 245-4990

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NPI Details

DR. Cullen Timothy Kehoe, DO is an emergency medicine in Lake Geneva, WI with 21 years of experience. The provider is an emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. DR. Cullen Timothy Kehoe, DO NPI is 1013166925. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: UNIVERSITY OF NORTH TEXAS HSC, COLLEGE OF OSTEOPATHIC MED
Graduation Year:2005

The provider's business location address is:

N2950 STATE ROAD 67
LAKE GENEVA, WI
ZIP 53147-655
Phone: (262) 245-4990
Fax: (262) 245-2248

The NPI 1013166925 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 9/16/2008 and was last updated on 4/28/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207P00000XEmergency Medicine11215NORTH DAKOTANo
2207P00000XEmergency Medicine036122047ILLINOISNo
3207P00000XEmergency Medicine53435-21WISCONSINYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11013166925MEDICAIDWISCONSIN
21013166925OTHERWISCONSINBCBSWI
3KEHOECULOTHERWISCONSINMERCYCARE INSURANCE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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