Active NPI
Jerome C Andres, MD
- Family Medicine Physician
- Rhinelander, WI
National Provider Identifier
1386750834
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 26743
- Practice address
- 1630 Chippewa Dr
Rhinelander, WI 54501-9503 - Phone
- (715) 361-5480
- Fax
- (715) 365-5258
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 26743 | WI | Primary |
Addresses
Primary practice location
1630 Chippewa Dr
Rhinelander, WI 54501-9503
Mailing address
1630 Chippewa Dr
Rhinelander, WI 54501-9503
Phone (715) 361-5480
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 |
|---|---|---|---|
| 26743 | WI | MD | 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": "1355961600000",
"number": "1386750834",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1630 CHIPPEWA DR",
"city": "RHINELANDER",
"state": "WI",
"postal_code": "545019503",
"telephone_number": "715-361-5480",
"fax_number": "715-365-5258"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1630 CHIPPEWA DR",
"city": "RHINELANDER",
"state": "WI",
"postal_code": "545019503",
"telephone_number": "715-361-5480",
"fax_number": "715-365-5258"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANDRES",
"first_name": "JEROME",
"middle_name": "C",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-21",
"last_updated": "2012-12-20",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "WI",
"license": "26743",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rhinelander, WI
- Advanced Medical Transport LLC
- Amanda Aerts
- Randall W Ahrens, MED LPC
- Margaret Joan Amundson, A.T.,C
- Kay E Anderson
- Roberta Apfel
- Arrow Transport 4U LLC
- Ascension Medical Group-Northern Wisconsin, Inc
- Ascension Medical Group-Northern Wisconsin, Inc
- Ascension Sacred Heart - St. Mary'S Hospitals, Inc.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 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.