Individual provider Active NPI

Robert Bruce Pierpont, MD

  • Family Medicine Physician
  • Superior, WI
National Provider Identifier
1497799464
Registry record updated Dec 23, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
31369-020 Issued in WI
Practice address
3500 Tower Ave
Superior, WI 54880-5335
Phone
(715) 817-7100
NPI assigned
Jun 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 31369-020 WI Primary

Addresses

Primary practice location

3500 Tower Ave
Superior, WI 54880-5335

Mailing address

3500 Tower Ave
Superior, WI 54880-5335
Phone (715) 817-7100

Other identifiers 1

IdentifierTypeStateIssuer
31625500MedicaidWI

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

LicenseStateTypeSpecialty
31369-020WIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Duluth Clinic, LTD. Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1150416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1387756800000",
    "number": "1497799464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3500 TOWER AVE",
            "city": "SUPERIOR",
            "state": "WI",
            "postal_code": "548805335",
            "telephone_number": "715-817-7100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3500 TOWER AVE",
            "city": "SUPERIOR",
            "state": "WI",
            "postal_code": "548805335",
            "telephone_number": "715-817-7100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PIERPONT",
        "first_name": "ROBERT",
        "middle_name": "BRUCE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-16",
        "last_updated": "2013-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "31369-020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "31625500",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Superior, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2013; 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.