Richard P. Jennings D.O. S. C.

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

29143 Issued in WI

Legal business name

RICHARD P. JENNINGS D.O. S. C.

Practice address

109 Warren St
Beaver Dam, WI 53916

Phone

(920) 887-8646

Fax

(920) 887-8953

NPI assigned

Oct 24, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Richard P Jennings, DO

Title

Physician Owner

Phone

(920) 887-8646

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213228800000",
    "number": "1043394562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 WARREN ST",
            "address_2": "SUITE #1",
            "city": "BEAVER DAM",
            "state": "WI",
            "postal_code": "539163082",
            "telephone_number": "920-887-8646",
            "fax_number": "920-887-8953"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 WARREN ST",
            "city": "BEAVER DAM",
            "state": "WI",
            "postal_code": "53916",
            "telephone_number": "920-887-8646",
            "fax_number": "920-887-8953"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RICHARD P. JENNINGS D.O. S. C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-24",
        "last_updated": "2008-06-12",
        "status": "A",
        "authorized_official_last_name": "JENNINGS",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "PHYSICIAN OWNER",
        "authorized_official_telephone_number": "920-887-8646",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Otolaryngology",
            "state": "WI",
            "license": "29143",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30042200",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ashley Lynn Rehbaum
• Reliv of Southern Wisconsin
• Timothy J Rentmeester, MD
• Courtney Rae Retzlaff, M.S. CCC-SLP
• J Scott Rhule, MA, LCSW, CSAC, ICS
• Joel Riehbrandt
• Carly Riley
• Carol Roddy, CSAC
• Raquel Rodriguez-Guzman, PHARMD
• Misty M Romero Rivera, APNP

• All providers in Beaver Dam, WI
• Otolaryngology Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2008; 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.