Individual provider Active NPI

Guy Edward Powers, MD

  • Psychiatry Physician
  • Marinette, WI
National Provider Identifier
1053415042
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
43059020 Issued in WI
Practice address
2500 Hall Ave
Suite a Marinette County Health and Human Services
Marinette, WI 54143
Phone
(715) 732-7760
Fax
(715) 732-7711
NPI assigned
Sep 11, 2006
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
Psychiatry Physician 2084P0800X 43059020 WI Primary

Addresses

Primary practice location

2500 Hall Ave
Suite a Marinette County Health and Human Services
Marinette, WI 54143

Mailing address

2500 Hall Ave
Suite a Marinette County Health and Human Services
Marinette, WI 54143
Phone (715) 732-7760

Other identifiers 2

IdentifierTypeStateIssuer
34097100MedicaidWI
43059020OtherWILICENSE #

Other names 1

  • Mr. Guy Edward Pienkos Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041220000149 WI Practitioner - Psychiatry 7810954039 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
County of MarinetteGroup PAC ID 3476513177, 4 clinicians

Practice addresses (Care Compare)

2500 Hall Ave
Suite a
Marinette, WI 54143-1656
Phone (715) 732-7714

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
43059020WIMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
County of Marinette CurrentSince Jul 6, 2001 Accepting new patients
County of Marinette CurrentSince Jul 6, 2001 Accepting new patients
County of Marinette Past Accepting new patients

Locations

2500 Hall Ave
Ste A
Marinette, WI 54143
Phone (715) 732-7760

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1157932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1053415042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 HALL AVE",
            "address_2": "SUITE A MARINETTE COUNTY HEALTH AND HUMAN SERVICES",
            "city": "MARINETTE",
            "state": "WI",
            "postal_code": "54143",
            "telephone_number": "715-732-7760",
            "fax_number": "715-732-7711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 HALL AVE",
            "address_2": "SUITE A MARINETTE COUNTY HEALTH AND HUMAN SERVICES",
            "city": "MARINETTE",
            "state": "WI",
            "postal_code": "54143",
            "telephone_number": "715-732-7760",
            "fax_number": "715-732-7711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POWERS",
        "first_name": "GUY",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-11",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WI",
            "license": "43059020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "34097100",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE #",
            "identifier": "43059020",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GUY",
            "last_name": "PIENKOS",
            "middle_name": "EDWARD",
            "prefix": "MR.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Marinette, WI

Sources for this page

Verify at the official NPI Registry.