Individual provider Active NPI

David G Lang, MD

  • Family Medicine Physician
  • Green Bay, WI
National Provider Identifier
1174515357
Registry record updated Nov 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
34640-20 Issued in WI
Practice address
3263 Eaton Rd
Green Bay, WI 54311-6830
Phone
(920) 433-6000
Fax
(920) 433-6009
NPI assigned
Aug 16, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 4301508402 MI
Family Medicine Physician 207Q00000X 36341 MN
Family Medicine Physician 207Q00000X 34640-20 WI Primary

Addresses

Primary practice location

3263 Eaton Rd
Green Bay, WI 54311-6830

Mailing address

PO Box 22487
Green Bay, WI 54305-2487
Phone (920) 445-7210

Other practice location 1

1630 Commanche Ave
Green Bay, WI 54313-5753
Phone (920) 430-4700

Other practice location 2

2820 Roosevelt Rd
Marinette, WI 54143-3834
Phone (715) 735-5225

Other practice location 3

440 Woodward Ave
Iron Mountain, MI 49801-4631
Phone (906) 776-9040

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, WI, MI3 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20051026000087 MN Practitioner - Family PracticePractitioner - Sports Medicine 3971415688 Reassigns benefits to 2 organizations
I20110131000760 WI Practitioner - Family PracticePractitioner - Emergency Medicine 3971415688 Reassigns benefits to 2 organizations
I20221223000077 MI Practitioner - Family Practice 3971415688 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Wisconsin School of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bellin Memorial Hospital IncGroup PAC ID 8820900749, shared by 10 NPIs, 685 clinicians

Practice addresses (Care Compare)

3263 Eaton Rd
Suite 1
Green Bay, WI 54311-6830
Phone (920) 433-6000

440 Woodward Ave
Iron Mountain, MI 49801-4631
Phone (906) 776-9040

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301508402MIMDFamily Medicine Physician
34640-20WIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Clinics CurrentSince Jun 4, 2011 Accepting new patients
Bellin Memorial Hospital Inc Family Medicine Current Accepting new patients
Fairview Clinics CurrentSince Jun 4, 2011 Accepting new patients
Fairview Clinics Current Accepting new patients
Fairview Health Services CurrentSince Jun 4, 2011 Accepting new patients
Fairview Health Services Current Accepting new patients
Oconto Hospital & Medical Center Inc CurrentSince Dec 20, 2022 Accepting new patients
Bellin Memorial Hospital Inc CurrentSince Dec 20, 2022 Accepting new patients
Bellin Memorial Hospital Inc Current Accepting new patients
Bellin Memorial Hospital Inc Family Medicine CurrentSince Dec 20, 2022 Accepting new patients
Oconto Hospital & Medical Center Inc Family Medicine CurrentSince Dec 20, 2022 Accepting new patients
Edina Sports Health & Wellness, PA Family Medicine PastSince Oct 4, 2010 Accepting new patients

Locations

440 Woodward Ave
Iron Mountain, MI 49801
Phone (906) 776-9040

1440 Duckwood Dr
Eagan, MN 55122
Phone (651) 406-8860

6401 France Ave S
Minneapolis, MN 55435
Phone (952) 920-8477

911 Northland Dr
Princeton, MN 55371
Phone (763) 389-1313

1630 Commanche Ave
Ste 102
Green Bay, WI 54313
Phone (920) 433-6000

3263 Eaton Rd
Green Bay, WI 54311
Phone (920) 433-6000

1630 Commanche Ave
Green Bay, WI 54313
Phone (920) 430-4700

3263 Eaton Rd
Ste 1
Green Bay, WI 54311
Phone (920) 433-6000

744 S Webster Ave
Green Bay, WI 54301
Phone (920) 433-6025

2820 Roosevelt Rd
Marinette, WI 54143
Phone (715) 330-6171

820 Arbutus Ave
Oconto, WI 54153
Phone (920) 835-1100

Interoperability endpoints

  • Direct secure messaging: dlang924693@direct.emplifyhealth.org

Organizations & group practices 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1124150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698969600000",
    "number": "1174515357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 22487",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543052487",
            "telephone_number": "920-445-7210",
            "fax_number": "920-445-7289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3263 EATON RD",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543116830",
            "telephone_number": "920-433-6000",
            "fax_number": "920-433-6009"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1630 Commanche Ave",
            "address_purpose": "LOCATION",
            "city": "Green Bay",
            "state": "WI",
            "postal_code": "543135753",
            "country_code": "US",
            "telephone_number": "920-430-4700",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2820 Roosevelt Rd",
            "address_purpose": "LOCATION",
            "city": "Marinette",
            "state": "WI",
            "postal_code": "541433834",
            "country_code": "US",
            "telephone_number": "715-735-5225",
            "fax_number": "715-735-5388",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "440 Woodward Ave",
            "address_purpose": "LOCATION",
            "city": "Iron Mountain",
            "state": "MI",
            "postal_code": "498014631",
            "country_code": "US",
            "telephone_number": "906-776-9040",
            "fax_number": "906-774-5950",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LANG",
        "first_name": "DAVID",
        "middle_name": "G",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-16",
        "last_updated": "2023-11-03",
        "certification_date": "2023-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301508402",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "36341",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "34640-20",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Green Bay, WI

Sources for this page

Verify at the official NPI Registry.