Individual provider Active NPI

Richard Dennis Sarnwick, DO

  • Family Medicine Physician
  • Shawano, WI
National Provider Identifier
1013944891
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
24612 Issued in WI
Practice address
1346 E Green Bay St
Shawano, WI 54166-2210
Phone
(715) 526-8800
NPI assigned
Jun 27, 2006
Last updated
Mar 7, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 24612 WI Primary

Addresses

Primary practice location

1346 E Green Bay St
Shawano, WI 54166-2210

Mailing address

1346 E Green Bay St
Shawano, WI 54166-2210
Phone (715) 526-8800

Other identifiers 1

IdentifierTypeStateIssuer
30017100MedicaidWI

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)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
24612WIMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1151366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1013944891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1346 E GREEN BAY ST",
            "city": "SHAWANO",
            "state": "WI",
            "postal_code": "541662210",
            "telephone_number": "715-526-8800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1346 E GREEN BAY ST",
            "city": "SHAWANO",
            "state": "WI",
            "postal_code": "541662210",
            "telephone_number": "715-526-8800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SARNWICK",
        "first_name": "RICHARD",
        "middle_name": "DENNIS",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-27",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "24612",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30017100",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shawano, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.