Individual provider Active NPI

Henry J Loomans, MD

  • Internal Medicine Physician
  • Oconto Falls, WI
National Provider Identifier
1174630628
Registry record updated Sep 2, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
35770 Issued in WI
Practice address
835 S Main St
Suite 1
Oconto Falls, WI 54154-1282
Phone
(920) 846-8187
Fax
(920) 846-2073
NPI assigned
Aug 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 35770 WI Primary
Infectious Disease Physician 207RI0200X 35770-20 WI

Addresses

Primary practice location

835 S Main St
Suite 1
Oconto Falls, WI 54154-1282

Mailing address

855 S Main St
Oconto Falls, WI 54154-1241
Phone (920) 846-3444

Other identifiers 7

IdentifierTypeStateIssuer
1326349135OtherWICMH SB NPI
1467583096OtherWICLINIC NPI
1174630628OtherWIBCBS
1851477913OtherWICMH NPI
11014110MedicaidWI
207R00000XMedicaidWI
390806395041OtherWICHAMPUS

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

State licenses

LicenseStateTypeSpecialty
35770WIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Clare Memorial Hospital, Inc Past Accepting new patients
St Clare Memorial Hospital, Inc. Past Accepting new patients
St Clare Memorial Hospital, Inc Past Accepting new patients
Community Memorial Hospital, Incorporated Past Accepting new patients
Community Memorial Hospital Past Accepting new patients
Holy Family Memorial Inc Past Accepting new patients
Community Memorial Hospital, Incorporated Past Accepting new patients
St Clare Memorial Hospital, Inc Past Accepting new patients
St Clare Memorial Hospital, Inc Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://eprescribe.sanfordhealth.org/FHIR/api/FHIR/R4/

Organizations & group practices 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1156291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409616000000",
    "number": "1174630628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "855 S MAIN ST",
            "city": "OCONTO FALLS",
            "state": "WI",
            "postal_code": "541541241",
            "telephone_number": "920-846-3444",
            "fax_number": "920-846-2073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "835 S MAIN ST",
            "address_2": "SUITE 1",
            "city": "OCONTO FALLS",
            "state": "WI",
            "postal_code": "541541282",
            "telephone_number": "920-846-8187",
            "fax_number": "920-846-2073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOOMANS",
        "first_name": "HENRY",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-23",
        "last_updated": "2014-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WI",
            "license": "35770",
            "primary": true
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "WI",
            "license": "35770-20",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CMH SB NPI",
            "identifier": "1326349135",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLINIC NPI",
            "identifier": "1467583096",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "1174630628",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CMH NPI",
            "identifier": "1851477913",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "11014110",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "207R00000X",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHAMPUS",
            "identifier": "390806395041",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oconto Falls, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2014; 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.