NPIMap

Individual provider Active NPI

Danielle M Covach, DO

  • Family Medicine Physician
  • Ripon, WI
National Provider Identifier
1073994018
Registry record updated Dec 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
66703 Issued in WI
Practice address
835 Parkside St
Ripon, WI 54971-8505
Phone
(920) 745-3520
Fax
(920) 745-3520
NPI assigned
Jun 16, 2015
Last updated
Dec 14, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2020

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 66703 WI Primary

Addresses

Primary practice location

835 Parkside St
Ripon, WI 54971-8505

Mailing address

835 Parkside St
Ripon, WI 54971-8335
Phone (920) 745-3520

Other names 1

  • Danielle M Fenske Former name

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address dfenske330559@direct-ehr-ssmhc.com Direct
FHIR URL https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/ Other

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180926000673 WI Practitioner - Family Practice 7810248101 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Agnesian Healthcare IncGroup PAC ID 1658289624, 392 clinicians

Practice addresses (Care Compare)

835 Parkside St
Ripon, WI 54971-8505
Phone (920) 748-3101

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
66703WIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Agnesian Healthcare, Inc Current Accepting new patients
Agnesian Healthcare Inc CurrentSince Aug 24, 2018 Accepting new patients
Agnesian Healthcare Inc Family Medicine CurrentSince Aug 24, 2018 Accepting new patients

Locations

420 E Division St
Fond du Lac, WI 54935
Phone (920) 923-7400

835 Parkside St
Ripon, WI 54971
Phone (920) 745-3520

Interoperability endpoints

  • Direct secure messaging: dfenske330559@direct-ehr-ssmhc.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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": "1434412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607904000000",
    "number": "1073994018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "835 PARKSIDE ST",
            "city": "RIPON",
            "state": "WI",
            "postal_code": "549718335",
            "telephone_number": "920-745-3520",
            "fax_number": "920-926-7932"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "835 PARKSIDE ST",
            "city": "RIPON",
            "state": "WI",
            "postal_code": "549718505",
            "telephone_number": "920-745-3520",
            "fax_number": "920-745-3520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COVACH",
        "first_name": "DANIELLE",
        "middle_name": "M",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-16",
        "last_updated": "2020-12-14",
        "certification_date": "2020-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "66703",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dfenske330559@direct-ehr-ssmhc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "dfenske330559@direct-ehr-ssmhc.com",
            "address_1": "835 Parkside St",
            "city": "Ripon",
            "state": "WI",
            "country_code": "US",
            "postal_code": "549718505",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "835 Parkside St",
            "city": "Ripon",
            "state": "WI",
            "country_code": "US",
            "postal_code": "549718505",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "DANIELLE",
            "last_name": "FENSKE",
            "middle_name": "M",
            "credential": "DO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Ripon, WI

Sources for this page

Verify at the official NPI Registry.