Thomas Paul Vansomeren, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

5151-015 Issued in WI

Practice address

404 Wisconsin Ave
Amery, WI 54001-1058

Phone

(715) 268-7177

Fax

(715) 268-5716

NPI assigned

Mar 7, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1173225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1558491464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "404 WISCONSIN AVE",
            "city": "AMERY",
            "state": "WI",
            "postal_code": "540011058",
            "telephone_number": "715-268-7177",
            "fax_number": "715-268-5716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "404 WISCONSIN AVE",
            "city": "AMERY",
            "state": "WI",
            "postal_code": "540011058",
            "telephone_number": "715-268-7177",
            "fax_number": "715-268-5716"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANSOMEREN",
        "first_name": "THOMAS",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "5151-015",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WI MEDICARE BADGERCARE",
            "identifier": "3375 6800",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• David R Toftness, D.C.
• Frances R Trowbridge, LCSW, CSAC
• Barry L. Tulkki, MD
• Lisa Ann Turek-Shay, DC
• Anders E Ulland, M.D.
• Jennifer E Waidelich, D.C.
• Anna Walker
• Ronnette L Walters, COTA
• Patricia Willeman
• Willow Ridge Healthcare Facilities, LLC

• General Practice Dentistry in Amery, WI
• Providers in Amery, WI by specialty
• General Practice Dentistry in Wisconsin

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.