Active NPI
Marc C Dummit, MD
- Emergency Medicine Physician
- Winona, MN
National Provider Identifier
1083631584
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- 39556
- Practice address
- 855 Mankato Ave
Winona, MN 55987-0006 - Phone
- (507) 457-4160
- Fax
- (507) 457-4160
- NPI assigned
- Jul 17, 2006
- Sex
- Male
- 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 | 39556 | MN | Primary |
Addresses
Primary practice location
855 Mankato Ave
Winona, MN 55987-0006
Mailing address
855 Mankato Ave
PO Box 5600
Winona, MN 55987-0006
Phone (507) 457-4160
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 53A34DU | Other | MN | BLUE CROSS BLUE SHIELD |
| 34151500 | Other | WI | MA |
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
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 39556 | MN | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Winona Health Services | Current | Accepting new patients |
Locations
420 E Sarnia St
Ste 2500
Winona, MN 55987
855 Mankato Ave
Winona, MN 55987
Phone (507) 454-3680
Organizations & group practices 1
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.
-
- General Acute Care Hospital
- Winona, MN
- NPI 1295789352
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153094400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1083631584",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "855 MANKATO AVE",
"address_2": "PO BOX 5600",
"city": "WINONA",
"state": "MN",
"postal_code": "559870006",
"telephone_number": "507-457-4160",
"fax_number": "507-457-4160"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "855 MANKATO AVE",
"city": "WINONA",
"state": "MN",
"postal_code": "559870006",
"telephone_number": "507-457-4160",
"fax_number": "507-457-4160"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUMMIT",
"first_name": "MARC",
"middle_name": "C",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-17",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "MN",
"license": "39556",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "53A34DU",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MA",
"identifier": "34151500",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Winona, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.