Active NPI
Kim R Riess-Sagers, MD
- Nephrology Physician
- Neenah, WI
National Provider Identifier
1235173121
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nephrology Physician
- License
- 32361
- Practice address
- 300 N Commercial St
Suite 200
Neenah, WI 54956-2619 - Phone
- (920) 886-0818
- Fax
- (920) 886-0773
- NPI assigned
- Jun 15, 2006
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Nephrology Physician | 207RN0300X | 32361 | WI | Primary |
Addresses
Primary practice location
300 N Commercial St
Suite 200
Neenah, WI 54956-2619
Mailing address
PO Box 22487
Green Bay, WI 54305-2487
Phone (920) 433-7864
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 21280500 | Medicaid | WI | |
| 31720300 | Medicaid | WI |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 32361 | WI | MD | Nephrology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Thedacare Medical Center - Shawano, Inc. | Past | Accepting new patients | |
| Bio-Medical Applications of Wisconsin, Inc. | Past | Accepting new patients | |
| Ascension Medical Group-Fox Valley Wisconsin, Inc | Past | Accepting new patients |
Organizations & group practices 3
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.
-
- Multi-Specialty Clinic/Center
- Neenah, WI
- NPI 1730126392
-
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Waupaca, WI
- NPI 1730116443
-
- Critical Access Hospital
- Shawano, WI
- NPI 1548260839
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150329600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1654041600000",
"number": "1235173121",
"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": "920-433-7864",
"fax_number": "920-445-7289"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 N COMMERCIAL ST",
"address_2": "SUITE 200",
"city": "NEENAH",
"state": "WI",
"postal_code": "549562619",
"telephone_number": "920-886-0818",
"fax_number": "920-886-0773"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RIESS-SAGERS",
"first_name": "KIM",
"middle_name": "R",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-15",
"last_updated": "2022-06-01",
"certification_date": "2022-06-01",
"status": "A"
},
"taxonomies": [
{
"code": "207RN0300X",
"taxonomy_group": "",
"desc": "Internal Medicine, Nephrology",
"state": "WI",
"license": "32361",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "21280500",
"state": "WI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "31720300",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Neenah, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.