Individual provider Active NPI

Richard E Gosse

  • General Practice Dentistry
  • Appleton, WI
National Provider Identifier
1285702415
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
522G Issued in WI
Practice address
2830 N Mason St
Appleton, WI 54914-1353
Phone
(920) 731-2356
Fax
(920) 731-5354
NPI assigned
Dec 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 522G WI Primary

Addresses

Primary practice location

2830 N Mason St
Appleton, WI 54914-1353

Mailing address

2830 N Mason St
Appleton, WI 54914-1353
Phone (920) 731-2356

Other identifiers 1

IdentifierTypeStateIssuer
33671300OtherWIMEDICAL ASSISTANCE(EDS)

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
522GWIMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Appleton Family Dentistry SC General Practice Past Accepting new patients

Organizations & group practices 1

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": "1165190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1285702415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2830 N MASON ST",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549141353",
            "telephone_number": "920-731-2356",
            "fax_number": "920-731-5354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2830 N MASON ST",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549141353",
            "telephone_number": "920-731-2356",
            "fax_number": "920-731-5354"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOSSE",
        "first_name": "RICHARD",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "522G",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL ASSISTANCE(EDS)",
            "identifier": "33671300",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Appleton, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.