Physical Medicine of Northern Wisconsin SC

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

Legal business name

PHYSICAL MEDICINE OF NORTHERN WISCONSIN SC

Practice address

586 Shepard St
Rhinelander, WI 54501

Phone

(715) 365-5256

Fax

(715) 365-5258

NPI assigned

Dec 1, 2006

Last updated

Feb 11, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Marc R Durette, MDNPI 1174628895

Title

Owner

Phone

(715) 365-5256

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Marc R. Durette, MD

  • Physical Medicine & Rehabilitation Physician
  • Rhinelander, WI
  • NPI 1174628895
  Authorized official Same address or phone

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

{
    "created_epoch": "1164931200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1202688000000",
    "number": "1235207085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "586 SHEPARD ST",
            "city": "RHINELANDER",
            "state": "WI",
            "postal_code": "54501",
            "telephone_number": "715-365-5256",
            "fax_number": "715-365-5258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "586 SHEPARD ST",
            "city": "RHINELANDER",
            "state": "WI",
            "postal_code": "54501",
            "telephone_number": "715-365-5256",
            "fax_number": "715-365-5258"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICAL MEDICINE OF NORTHERN WISCONSIN SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-01",
        "last_updated": "2008-02-11",
        "status": "A",
        "authorized_official_last_name": "DURETTE",
        "authorized_official_first_name": "MARC",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "715-365-5256",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "31572600",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Petersen Health Care of Wi, Inc. (Friendly Village)
• Petersen Health Care of Wi, Inc. (Taylor Park Health Care and Rehabilitation Center)
• Petersen Rehabilitation Center, Inc. (Horizons Unlimited)
• Nicole Marie Peterson, FNP-C
• Shawn Ann Pflugardt, PSY.D.
• Physical Therapy Center of Rhinelander, Inc.
• Julia Elizabeth Pickens, M.D.
• Stephanie Ann Pittman, ED.D.
• Bridget Plautz
• Jennifer Podeweltz, SAC-IT

• Physical Medicine & Rehabilitation Physician in Rhinelander, WI
• Providers in Rhinelander, WI by specialty
• Physical Medicine & Rehabilitation Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2008; 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.