Daniel G Cavanaugh, MD

Primary specialty

Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X

License

27940 Issued in WI

Practice address

N1050 County Road O
Mondovi, WI 54755-8886

Phone

(715) 875-4402

NPI assigned

Oct 5, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Marshfield Clinic Inc

  • Clinic/Center
  • Marshfield, WI
  • NPI 1952347981

  Surgery

  NPD

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1285200000000",
    "number": "1104912153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "N1050 COUNTY ROAD O",
            "city": "MONDOVI",
            "state": "WI",
            "postal_code": "547558886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "N1050 COUNTY ROAD O",
            "city": "MONDOVI",
            "state": "WI",
            "postal_code": "547558886",
            "telephone_number": "715-875-4402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAVANAUGH",
        "first_name": "DANIEL",
        "middle_name": "G",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-05",
        "last_updated": "2010-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "WI",
            "license": "27940",
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "WI",
            "license": "27940",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30763200",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Charles D Bantle, DO
• Jennifer Bargmann, MS
• Linda J Becher, RN
• Ivy Sue Bielefeldt, FNP
• Indigo Yves Brown, D.O.
• Jessica Marie Clauson
• Durand Optometry Clinic LLC Dba Mondovi Eye and Optical
• Tonya Dziekan
• Sydney Jean Ede
• Susan Evans-Poeschel

• All providers in Mondovi, WI
• Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.