Active NPI
Jon Christopher Daubner, PA
- Physician Assistant
- Green Bay, WI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 2585-23
- Practice address
- 1630 Commanche Ave
Green Bay, WI 54313-5753 - Phone
- (920) 430-4560
- NPI assigned
- Jun 9, 2010
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 2585-23 | WI | Primary |
Addresses
Primary practice location
1630 Commanche Ave
Green Bay, WI 54313-5753
Mailing address
PO Box 22487
Green Bay, WI 54305-2487
Phone (920) 445-7210
Other practice location 1
311 N 3rd Ave
Sturgeon Bay, WI 54235-2401
Phone (920) 743-0255
Other practice location 2
2820 Roosevelt Rd
Marinette, WI 54143-3834
Phone (715) 735-5225
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1086997 | Other | NATIONAL COMMISSION ON CERTIFIED PHYSICIAN ASSISTANTS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2010
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2020 S Webster Ave
Accounting
Green Bay, WI 54301-3505
744 S Webster Ave
Green Bay, WI 54301-3505
820 Arbutus Ave
Oconto, WI 54153-2004
Phone (920) 835-1100
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2585-23 | WI | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bellin Memorial Hospital Inc | Current | Accepting new patients | |
| Oconto Hospital & Medical Center, Inc. | Current | Accepting new patients | |
| Oconto Hospital & Medical Center Inc | Current | Accepting new patients |
Locations
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
- jdaubner925028@direct.emplifyhealth.org
- jdaubner62497@direct.thedacare.org
Organizations & group practices 5
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.
-
- Rural Health Clinic/Center
- Algoma, WI
- NPI 1609838473
-
- Critical Access Hospital
- Oconto, WI
- NPI 1356373302
-
- Allergy & Immunology Physician
- Green Bay, WI
- NPI 1316286941
-
- Rural Health Clinic/Center
- Suring, WI
- NPI 1104418037
-
- Rural Health Clinic/Center
- Oconto, WI
- NPI 1609018589
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Green Bay, WI
- NPI 1891740585
-
- Critical Access Hospital
- Oconto, WI
- NPI 1356373302
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1276041600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1669075200000",
"number": "1174843452",
"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": "1630 COMMANCHE AVE",
"city": "GREEN BAY",
"state": "WI",
"postal_code": "543135753",
"telephone_number": "920-430-4560"
}
],
"practiceLocations": [
{
"address_1": "311 N 3rd Ave",
"address_purpose": "LOCATION",
"city": "Sturgeon Bay",
"state": "WI",
"postal_code": "542352401",
"country_code": "US",
"telephone_number": "920-743-0255",
"fax_number": "920-743-6680",
"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"
}
],
"basic": {
"last_name": "DAUBNER",
"first_name": "JON",
"middle_name": "CHRISTOPHER",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-06-09",
"last_updated": "2022-11-22",
"certification_date": "2022-11-22",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "WI",
"license": "2585-23",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NATIONAL COMMISSION ON CERTIFIED PHYSICIAN ASSISTANTS",
"identifier": "1086997",
"state": null
}
],
"endpoints": [],
"other_names": []
}
Other providers in Green Bay, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.