Timothy Wycoff, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

29597 Issued in WI

Practice address

2500 E Capitol Dr
Appleton, WI 54911-8735

Phone

(920) 738-4600

Fax

(920) 738-4792

NPI assigned

Jun 28, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Thedacare Medical Center - Shawano, Inc.

  • Critical Access Hospital
  • Shawano, WI
  • NPI 1548260839
  NPD (past)

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

{
    "created_epoch": "1151452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327536000000",
    "number": "1295762680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8003",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549128003",
            "telephone_number": "920-996-3298",
            "fax_number": "920-738-5787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 E CAPITOL DR",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549118735",
            "telephone_number": "920-738-4600",
            "fax_number": "920-738-4792"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYCOFF",
        "first_name": "TIMOTHY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-28",
        "last_updated": "2012-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "29597",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "31612600",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Holly Jane Wruck
• Kendra E Wuest, LCSW
• Alexis Wunrow
• James Chester Wurl, R.PH.
• Shirley Ann Wurzer, RN
• David Cameron Wygle
• Lorelei Wyman, LPN
• Hue Xiong
• Ka Xiong, APSW
• Simon Richard Yadgir

• Family Medicine Physician in Appleton, WI
• Providers in Appleton, WI by specialty
• Family Medicine Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2012; 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.