Active NPI
Barbara Southworth, RDH
- Dental Hygienist
- Bloomer, WI
National Provider Identifier
1104293091
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- 5432-16
- Practice address
- 1904 5TH Ave
Bloomer, WI 54724-1291 - Phone
- (715) 296-1649
- NPI assigned
- Aug 26, 2015
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Dental Hygienist | 124Q00000X | 5432-16 | WI | Primary |
Addresses
Primary practice location
1904 5TH Ave
Bloomer, WI 54724-1291
Mailing address
1904 5TH Ave
Bloomer, WI 54724-1291
Phone (715) 296-1649
Other names 1
- Barbara Fehr
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5432-16 | WI | MD | Dental Hygienist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1440547200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1440547200000",
"number": "1104293091",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1904 5TH AVE",
"city": "BLOOMER",
"state": "WI",
"postal_code": "547241291",
"telephone_number": "715-296-1649"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1904 5TH AVE",
"city": "BLOOMER",
"state": "WI",
"postal_code": "547241291",
"telephone_number": "715-296-1649"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SOUTHWORTH",
"first_name": "BARBARA",
"credential": "RDH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-08-26",
"last_updated": "2015-08-26",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "WI",
"license": "5432-16",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "BARBARA",
"last_name": "FEHR",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Bloomer, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.