Active NPI
Sandra J Riebe, PA-C
- Emergency Medicine Physician
- Stillwater, MN
National Provider Identifier
1073657789
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- 555
- Practice address
- 927 Churchill St W
Stillwater, MN 55082-6605 - Phone
- (651) 439-5330
- NPI assigned
- Feb 16, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 555 | CO | Primary |
Addresses
Primary practice location
927 Churchill St W
Stillwater, MN 55082-6605
Mailing address
827 S Piety St
Ellsworth, WI 54011-9133
Phone (715) 273-4585
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 005972 | Other | KAISER-COMMERCIAL NUMBER |
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
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 555 | CO | MD | Emergency Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171584000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1212710400000",
"number": "1073657789",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "827 S PIETY ST",
"city": "ELLSWORTH",
"state": "WI",
"postal_code": "540119133",
"telephone_number": "715-273-4585"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "927 CHURCHILL ST W",
"city": "STILLWATER",
"state": "MN",
"postal_code": "550826605",
"telephone_number": "651-439-5330"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RIEBE",
"first_name": "SANDRA",
"middle_name": "J",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-16",
"last_updated": "2008-06-06",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "CO",
"license": "555",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "KAISER-COMMERCIAL NUMBER",
"identifier": "005972",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Stillwater, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 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.