Active NPI
Constantine Dumas, MD, PHD, MPH
- Preventive Medicine/Occupational Environmental Medicine Physician
- Appleton, WI
National Provider Identifier
1083640502
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Preventive Medicine/Occupational Environmental Medicine Physician
- License
- 01059571A
- Practice address
- 2009 S Memorial Dr
Appleton, WI 54915-1222 - Phone
- (920) 380-4999
- NPI assigned
- Jun 25, 2006
- Last updated
- Jun 13, 2008
- 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 |
|---|---|---|---|---|
| Preventive Medicine/Occupational Environmental Medicine Physician | 2083P0500X | 01059571A | IN | Primary |
Addresses
Primary practice location
2009 S Memorial Dr
Appleton, WI 54915-1222
Mailing address
W4887 Escarpment Ter
Sherwood, WI 54169-9760
Phone (920) 507-0083
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, Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01059571A | IN | MD | Preventive Medicine/Occupational Environmental Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Thedacare, Incorporated | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba ThedaCare Physicians
- Family Medicine Physician
- New London, WI
- NPI 1376656959
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151193600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1213315200000",
"number": "1083640502",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "W4887 ESCARPMENT TER",
"city": "SHERWOOD",
"state": "WI",
"postal_code": "541699760",
"telephone_number": "920-507-0083"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2009 S MEMORIAL DR",
"city": "APPLETON",
"state": "WI",
"postal_code": "549151222",
"telephone_number": "920-380-4999"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUMAS",
"first_name": "CONSTANTINE",
"name_prefix": "Dr.",
"credential": "MD, PHD, MPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-25",
"last_updated": "2008-06-13",
"status": "A"
},
"taxonomies": [
{
"code": "2083P0500X",
"taxonomy_group": "",
"desc": "Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine",
"state": "IN",
"license": "01059571A",
"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 Jun 13, 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.