Individual provider Active NPI

Philip Andrew Madson, DDS

  • Dentist
  • Rhinelander, WI
National Provider Identifier
1376622076
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
5001216015 Issued in WI
Practice address
18 East Davenport Street
Rhinelander, WI 54501
Phone
(715) 369-2263
Fax
(715) 369-0731
NPI assigned
Nov 3, 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
Dentist 122300000X 5001216015 WI Primary

Addresses

Primary practice location

18 East Davenport Street
Rhinelander, WI 54501

Mailing address

PO Box 735
18 East Davenport
Rhinelander, WI 54501
Phone (715) 369-2263

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
5001216015WIMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1162512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1376622076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 735",
            "address_2": "18 EAST DAVENPORT",
            "city": "RHINELANDER",
            "state": "WI",
            "postal_code": "54501",
            "telephone_number": "715-369-2263",
            "fax_number": "715-369-0731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18 EAST DAVENPORT STREET",
            "city": "RHINELANDER",
            "state": "WI",
            "postal_code": "54501",
            "telephone_number": "715-369-2263",
            "fax_number": "715-369-0731"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADSON",
        "first_name": "PHILIP",
        "middle_name": "ANDREW",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WI",
            "license": "5001216015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rhinelander, 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.