Active NPI
Gary A Schmidt, M.D.
- Family Medicine Physician
- Manitowoc, WI
National Provider Identifier
1326154725
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 21523
- Practice address
- 1650 S 41St St
Manitowoc, WI 54220-7316 - Phone
- (920) 320-4500
- Fax
- (920) 682-9378
- NPI assigned
- Aug 21, 2006
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 21523 | WI | Primary |
| Addiction Medicine (Family Medicine) Physician | 207QA0401X | 21523 | WI |
Addresses
Primary practice location
1650 S 41St St
Manitowoc, WI 54220-7316
Mailing address
PO Box 2290
Manitowoc, WI 54221-2290
Phone (920) 320-4500
Other identifiers 9
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0001598644 02 | Other | WI | UNITED HEALTH |
| 12521 | Other | WI | NETWORK HEALTH PLAN |
| 30174800 | Medicaid | WI | |
| 390806395 | Other | WI | CHAMPUS |
| 390806395 | Other | WI | WEA |
| 39080639508 | Other | WI | TRICARE |
| B56376 | Other | WI | CIGNA |
| 080125211 | Other | WI | MEDICARE RAILROAD |
| 21523 | Other | WI | TOUCHPOINT |
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 |
|---|---|---|---|
| 21523 | WI | MD | Addiction Medicine (Family Medicine) Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156118400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1212019200000",
"number": "1326154725",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2290",
"city": "MANITOWOC",
"state": "WI",
"postal_code": "542212290",
"telephone_number": "920-320-4500",
"fax_number": "920-682-9378"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1650 S 41ST ST",
"city": "MANITOWOC",
"state": "WI",
"postal_code": "542207316",
"telephone_number": "920-320-4500",
"fax_number": "920-682-9378"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SCHMIDT",
"first_name": "GARY",
"middle_name": "A",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-21",
"last_updated": "2008-05-29",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "WI",
"license": "21523",
"primary": true
},
{
"code": "207QA0401X",
"taxonomy_group": "",
"desc": "Family Medicine, Addiction Medicine",
"state": "WI",
"license": "21523",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTH",
"identifier": "0001598644 02",
"state": "WI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NETWORK HEALTH PLAN",
"identifier": "12521",
"state": "WI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "30174800",
"state": "WI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CHAMPUS",
"identifier": "390806395",
"state": "WI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WEA",
"identifier": "390806395",
"state": "WI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRICARE",
"identifier": "39080639508",
"state": "WI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "B56376",
"state": "WI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE RAILROAD",
"identifier": "080125211",
"state": "WI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TOUCHPOINT",
"identifier": "21523",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Manitowoc, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 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.