Individual provider Active NPI

Karen Rodman, RDH

  • Dental Hygienist
  • Appleton, WI
National Provider Identifier
1053075481
Registry record updated May 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental HygienistTaxonomy code 124Q00000X
License
1002933-16 Issued in WI
Practice address
5337 W Grande Market Dr
Appleton, WI 54913-8442
Phone
(920) 731-7445
Fax
(920) 882-2946
NPI assigned
Oct 22, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Hygienist 124Q00000X 1002933-16 WI Primary

Addresses

Primary practice location

5337 W Grande Market Dr
Appleton, WI 54913-8442

Mailing address

119 N McCarthy Rd Ste S
Appleton, WI 54913-9112
Phone (920) 750-6644

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
1002933-16WIMDDental Hygienist

NPI Registry JSON

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

{
    "created_epoch": "1634860800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714953600000",
    "number": "1053075481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 N MCCARTHY RD STE S",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549139112",
            "telephone_number": "920-750-6644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5337 W GRANDE MARKET DR",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549138442",
            "telephone_number": "920-731-7445",
            "fax_number": "920-882-2946"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODMAN",
        "first_name": "KAREN",
        "credential": "RDH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-22",
        "last_updated": "2024-05-06",
        "certification_date": "2024-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "WI",
            "license": "1002933-16",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Appleton, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2024; 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.