Individual provider Active NPI

Ronald Andrew Rimmer, M.D.

  • Family Medicine Physician
  • Manitowoc, WI
National Provider Identifier
1568414910
Registry record updated Feb 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
07070683A Issued in IN
Practice address
4303 Michigan Ave
Manitowoc, WI 54220-3066
Phone
(920) 320-2436
NPI assigned
May 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 00024621 AL
Family Medicine Physician 207Q00000X 07070683A IN Primary

Addresses

Primary practice location

4303 Michigan Ave
Manitowoc, WI 54220-3066

Mailing address

PO Box 2290
Manitowoc, WI 54221-2290
Phone (920) 320-4070

Other identifiers 3

IdentifierTypeStateIssuer
201055980MedicaidIN
009982710MedicaidAL
09137OtherALBCBS

Other names 1

  • Andy Rimmer Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, GA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20090722000587 WI Practitioner - Pediatric Medicine 6709938780 Reassigns benefits to 1 organization
I20130723000864 GA Practitioner - Pediatric Medicine 6709938780 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
00024621ALMDSpecialist
07070683AINMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Froedtert Manitowoc Medical Group, LLC CurrentSince Jun 10, 2022 Accepting new patients
Au Medical Associates Inc CurrentSince Aug 1, 2013 Accepting new patients
Au Medical Associates Inc CurrentSince Aug 1, 2013 Accepting new patients
Holy Family Memorial Inc Past Accepting new patients
Saint Joseph Regional Medical Center, Inc. Family Medicine Past Accepting new patients

Locations

1120 15th St
Augusta, GA 30912
Phone (706) 721-3873

1499 Walton Way
Ste 1400
Augusta, GA 30901
Phone (706) 721-4951

4303 Michigan Ave
Manitowoc, WI 54220
Phone (920) 320-4300

1414 N Taylor Dr
Sheboygan, WI 53081
Phone (920) 320-2011

Interoperability endpoints

  • Direct secure messaging: rrimmer544118@direct.froedtert.com

Organizations & group practices 5

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": "1147737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613606400000",
    "number": "1568414910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2290",
            "city": "MANITOWOC",
            "state": "WI",
            "postal_code": "542212290",
            "telephone_number": "920-320-4070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4303 MICHIGAN AVE",
            "city": "MANITOWOC",
            "state": "WI",
            "postal_code": "542203066",
            "telephone_number": "920-320-2436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIMMER",
        "first_name": "RONALD",
        "middle_name": "ANDREW",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-16",
        "last_updated": "2021-02-18",
        "certification_date": "2021-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "AL",
            "license": "00024621",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "07070683A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201055980",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009982710",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "09137",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANDY",
            "last_name": "RIMMER",
            "credential": "M.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Manitowoc, WI

Sources for this page

Verify at the official NPI Registry.