Nino Anton Vidic, M.D.

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

50281 Issued in WI

Practice address

4907B Keystone Xing
Eau Claire, WI 54701-5144

Phone

(715) 514-1585

Fax

(715) 514-1652

NPI assigned

Oct 26, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• St Josephs Hospital of the Hospital Sisters of the Third Order of St F

  • General Acute Care Hospital
  • Chippewa Falls, WI
  • NPI 1164429908
  NPD (past)

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

{
    "created_epoch": "1130284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532476800000",
    "number": "1467442921",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 SEVEN SPRINGS WAY",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370275098",
            "telephone_number": "615-920-7000",
            "fax_number": "615-920-8775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4907B KEYSTONE XING",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "547015144",
            "telephone_number": "715-514-1585",
            "fax_number": "715-514-1652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIDIC",
        "first_name": "NINO",
        "middle_name": "ANTON",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-26",
        "last_updated": "2018-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "WI",
            "license": "50281",
            "primary": true
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "NE",
            "license": "21748",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "NM",
            "license": "MD2005-0644",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pieter Eugene Ver Steeg
• Juan Pablo Vera Gomez, M.D.
• Jessica M Vera Santiago, RN
• Karen Sue Vesperman, OTR
• Katrina Victoria, MD
• Diana Vielmas
• Tamara Viergutz
• Chad Vieth, O.D.
• Shana L Vifian Ray, M.D.
• Adam Vinz, CRNA

• Child & Adolescent Psychiatry Physician in Eau Claire, WI
• Providers in Eau Claire, WI by specialty
• Child & Adolescent Psychiatry Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2018; 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.