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DARREN R. ELLENBOLT M.D.
NPI 1700855012
Family Medicine in Mukwonago, WI

Active since March 17, 2006
240 MAPLE AVE., PROHEALTH CARE MEDICAL ASSOCIATES, INC., MUKWONAGO, WI 53149(262) 928-1900(262) 363-1949 Get Directions Write a Review

NPPES record last updated: November 2, 2011. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Darren R. Ellenbolt M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DARREN R. ELLENBOLT M.D. (NPI 1700855012) is an individual family medicine provider in Mukwonago, Wisconsin, licensed in Wisconsin (47860) and active in the NPI registry since March 2006.

NPPES Registry Identity

NPI1700855012
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameDARREN R. ELLENBOLTCredential: M.D.
Location Address240 MAPLE AVE., PROHEALTH CARE MEDICAL ASSOCIATES, INC.Mukwonago, WI 53149-8475
Mailing AddressN17 W24100 Riverwood Dr., Prohealth Care Medical Associates, Inc.Waukesha, WI 53188-1177 · (262) 928-4100 · Fax (262) 928-5835
Phone(262) 928-1900
Fax(262) 363-1949
Sole ProprietorNo
Enumeration DateMarch 17, 2006
Last NPPES UpdateNovember 2, 2011
✔ NPI 1700855012 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in WI · 47860
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
240 MAPLE AVE., Mukwonago, WI 53149
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Other Identifiers 4

Medicaid34847400WI
Medicare UPINI55617WI
Medicare PIN683750606WI
Medicare PIN011668605WI

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

STEVEN C. FEHR M.D.
Family Medicine
240 MAPLE AVE., PROHEALTH CARE MEDICAL ASSOCIATES, INC.
MUKWONAGO, WI 53149
Waukesha County (262) 928-1900
JILL C. LARSON D.O.
Family Medicine
240 MAPLE AVE., PROHEALTH CARE MEDICAL ASSOCIATES, INC.
MUKWONAGO, WI 53149
Waukesha County (262) 928-1900

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Darren Ellenbolt's NPI number?

The NPI number for Darren Ellenbolt is 1700855012. It was assigned to this individual provider in the NPPES registry on March 17, 2006.

Where is Darren Ellenbolt located?

Darren Ellenbolt practices at 240 Maple Ave. Prohealth Care Medical Associates, Inc., Mukwonago, WI 53149. The listed phone number is (262) 928-1900.

What is Darren Ellenbolt's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

When was this NPI record last updated?

The NPPES record for Darren Ellenbolt was last updated on November 2, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.