Active NPI
Anne Drewry, MD
- Family Medicine Physician
- Minocqua, WI
National Provider Identifier
1417030867
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 35195
- Practice address
- 9601 Townline Rd
Minocqua, WI 54548 - Phone
- (715) 358-1169
- NPI assigned
- Oct 21, 2006
- Reactivated
- Dec 19, 2018
- Sex
- Female
- 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 | 35195 | WI | Primary |
Addresses
Primary practice location
9601 Townline Rd
Minocqua, WI 54548
Mailing address
1411 N Taylor Dr
Sheboygan, WI 53081-3043
Phone (920) 496-4700
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 32058500 | Medicaid | WI |
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 |
|---|---|---|---|
| 35195 | WI | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161388800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1589760000000",
"number": "1417030867",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1411 N TAYLOR DR",
"city": "SHEBOYGAN",
"state": "WI",
"postal_code": "530813043",
"telephone_number": "920-496-4700"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9601 TOWNLINE RD",
"city": "MINOCQUA",
"state": "WI",
"postal_code": "54548",
"telephone_number": "715-358-1169"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DREWRY",
"first_name": "ANNE",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-21",
"last_updated": "2020-05-18",
"certification_date": "2020-05-18",
"deactivation_date": "2018-08-26",
"reactivation_date": "2018-12-19",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "WI",
"license": "35195",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "32058500",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Minocqua, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.