Individual provider Active NPI

Richard Arthur Brandner, M.D.

  • Family Medicine Physician
  • Crandon, WI
National Provider Identifier
1598954398
Registry record updated Sep 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
19956 Issued in WI
Practice address
3144 Vanzile Rd
Crandon, WI 54520-8149
Phone
(715) 478-5180
NPI assigned
Oct 17, 2007
Last updated
Sep 8, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2022

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 19956 WI Primary

Addresses

Primary practice location

3144 Vanzile Rd
Crandon, WI 54520-8149

Mailing address

400 West Glen St
Crandon, WI 54520-1355
Phone (715) 478-3318

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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 1

Enrollment IDStateProvider typePAC IDDetails
I20040601000039 WI Practitioner - Family PracticePractitioner - General Practice 8527049931 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Medical College of Wisconsin, 1975
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sokaogon Chippewa CommunityGroup PAC ID 1759370869, 13 clinicians

Practice addresses (Care Compare)

3144 Vanzile Rd
Crandon, WI 54520-8149
Phone (715) 478-5180

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
19956WIMDFamily Medicine Physician

Interoperability endpoints

  • Direct secure messaging: richard.brandner@schc.directbygreenway.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1192579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662595200000",
    "number": "1598954398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 WEST GLEN ST",
            "city": "CRANDON",
            "state": "WI",
            "postal_code": "545201355",
            "telephone_number": "715-478-3318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3144 VANZILE RD",
            "city": "CRANDON",
            "state": "WI",
            "postal_code": "545208149",
            "telephone_number": "715-478-5180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRANDNER",
        "first_name": "RICHARD",
        "middle_name": "ARTHUR",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-10-17",
        "last_updated": "2022-09-08",
        "certification_date": "2022-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "19956",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crandon, WI

Sources for this page

Verify at the official NPI Registry.