Individual provider Active NPI

Emily Favret, D.O.

  • Family Medicine Physician
  • Oshkosh, WI
National Provider Identifier
1346624178
Registry record updated Aug 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
67124 Issued in WI
Practice address
500 S Oakwood Rd
Oshkosh, WI 54904
Phone
(920) 223-2000
NPI assigned
Jul 10, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 29, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X 67124 WI Primary

Addresses

Primary practice location

500 S Oakwood Rd
Oshkosh, WI 54904

Mailing address

500 S Oakwood Rd
Oshkosh, WI 54904-7944
Phone (920) 223-2000

Other practice location 1

191 Theater Rd
Onalaska, WI 54650-8679
Phone (608) 392-5000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180129000564 WI Practitioner - HospitalistPractitioner - Family Practice 3072873702 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Family Practice
Education
Midwestern University, Chicago College of Osteopathic Med, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ascension Medical Group-Fox Valley Wisconsin, IncGroup PAC ID 0244142420, 260 clinicians

Practice addresses (Care Compare)

500 S Oakwood Rd
Oshkosh, WI 54904-7944
Phone (920) 223-2000

Hospital & facility affiliations

  • Ascension NE Wisconsin - St Elizabeth Campus Hospital, Appleton, WI, CCN 520009

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Ascension NE Wisconsin, Inc CurrentSince Aug 27, 2018 Accepting new patients
Ascension Medical Group-Fox Valley Wisconsin, Inc CurrentSince Aug 27, 2018 Accepting new patients
Ascension NE Wisconsin, Inc CurrentSince Aug 27, 2018 Accepting new patients
Ascension Medical Group-Fox Valley Wisconsin, Inc CurrentSince Aug 27, 2018 Accepting new patients
Mayo Clinic Health System-Southwest Wisconsin Region, Inc. Past Accepting new patients

Locations

1506 S Oneida St
Appleton, WI 54915
Phone (920) 730-4950

1501 S Madison St
Appleton, WI 54915
Phone (920) 730-4435

500 S Oakwood Rd
Oshkosh, WI 54904
Phone (920) 223-0501

2700 W 9th Ave
Oshkosh, WI 54904
Phone (920) 223-0220

Organizations & group practices 5

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1436486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535500800000",
    "number": "1346624178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 S OAKWOOD RD",
            "city": "OSHKOSH",
            "state": "WI",
            "postal_code": "549047944",
            "telephone_number": "920-223-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 S OAKWOOD RD",
            "city": "OSHKOSH",
            "state": "WI",
            "postal_code": "54904",
            "telephone_number": "920-223-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "191 Theater Rd",
            "address_purpose": "LOCATION",
            "city": "Onalaska",
            "state": "WI",
            "postal_code": "546508679",
            "country_code": "US",
            "telephone_number": "608-392-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FAVRET",
        "first_name": "EMILY",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-07-10",
        "last_updated": "2018-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "67124",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oshkosh, WI

Sources for this page

Verify at the official NPI Registry.