NPIMap

Individual provider Active NPI

Andrew Michael Dunn, D.O

  • Family Medicine Physician
  • Neenah, WI
National Provider Identifier
1093078420
Registry record updated Jun 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
1724 Issued in WI
Practice address
333 N Green Bay Rd
Neenah, WI 54956-1954
Phone
(920) 729-6088
NPI assigned
Jun 20, 2012
Last updated
Jun 2, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036-136190 IL
Family Medicine Physician 207Q00000X 1724 WI Primary

Addresses

Primary practice location

333 N Green Bay Rd
Neenah, WI 54956-1954

Mailing address

3 Neenah Ctr
Neenah, WI 54956-3070
Phone (920) 729-6088

Other practice location 1

927 Broadway St
Quincy, IL 62301-2719
Phone (217) 223-8400

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Cobius Healthcare Solutions

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, WI2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20151110001159 IL Practitioner - Family Practice 2567680598 Reassigns benefits to 1 organization
I20230710001456 WI Practitioner - Family Practice 2567680598 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Des Moines University of Osteopathic Medicine and Health Sciences, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Thedacare, IncorporatedGroup PAC ID 1759294887, 654 clinicians

Practice addresses (Care Compare)

333 N Green Bay Rd
Neenah, WI 54956-1954
Phone (920) 364-3600

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-136190ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sound Physicians of Illinois, LLC Family Medicine CurrentSince Dec 1, 2015 Accepting new patients
Thedacare, Incorporated CurrentSince Jun 10, 2023 Accepting new patients
Thedacare, Incorporated Family Medicine CurrentSince Jun 10, 2023 Accepting new patients
Thedacare Medical Center - Berlin, Inc. Past Accepting new patients

Locations

1044 N Francisco Ave
Chicago, IL 60622
Phone (773) 292-8227

1005 Broadway St
Quincy, IL 62301

4480 W Spencer St
Appleton, WI 54914
Phone (920) 738-4800

3 Neenah Ctr
Neenah, WI 54956
Phone (920) 454-4229

333 N Green Bay Rd
Neenah, WI 54956
Phone (920) 725-2070

600 N Westhaven Dr
Oshkosh, WI 54904
Phone (920) 237-5000

Interoperability endpoints

  • Direct secure messaging: adunn332102@direct.thedacare.org

Organizations & group practices 4

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 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1340150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685664000000",
    "number": "1093078420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 NEENAH CTR",
            "city": "NEENAH",
            "state": "WI",
            "postal_code": "549563070",
            "telephone_number": "920-729-6088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 N GREEN BAY RD",
            "city": "NEENAH",
            "state": "WI",
            "postal_code": "549561954",
            "telephone_number": "920-729-6088"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "927 Broadway St",
            "address_purpose": "LOCATION",
            "city": "Quincy",
            "state": "IL",
            "postal_code": "623012719",
            "country_code": "US",
            "telephone_number": "217-223-8400",
            "fax_number": "217-228-3251",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DUNN",
        "first_name": "ANDREW",
        "middle_name": "MICHAEL",
        "credential": "D.O",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-20",
        "last_updated": "2023-06-02",
        "certification_date": "2023-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036-136190",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "1724",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1068.1",
            "affiliationName": "Cobius Healthcare Solutions",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "2720 Dundee Rd # 302",
            "city": "Northbrook",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600622609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Neenah, WI

Sources for this page

Verify at the official NPI Registry.