Anna Fedak Botts, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

6443 Issued in WI

Practice address

449 S 1St St
Evansville, WI 53536-1394

Phone

(608) 882-4338

Fax

(608) 882-6777

NPI assigned

Aug 25, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1251158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1252454400000",
    "number": "1609009661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "449 S 1ST ST",
            "city": "EVANSVILLE",
            "state": "WI",
            "postal_code": "535361394",
            "telephone_number": "608-882-4338",
            "fax_number": "608-882-6777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "449 S 1ST ST",
            "city": "EVANSVILLE",
            "state": "WI",
            "postal_code": "535361394",
            "telephone_number": "608-882-4338",
            "fax_number": "608-882-6777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOTTS",
        "first_name": "ANNA",
        "middle_name": "FEDAK",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-25",
        "last_updated": "2009-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "6443",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "18830",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gina Auel, MS CCC-SLP
• Meagan Barker, PT, DPT, ATC
• Karen G Bassham, RN
• Allison Rae Becker, N.D., LAC
• Hailey Bomar, DPT
• Sarah Ann Burd
• Ashley Nicole Carrington, DPT
• City of Evansville
• Frances Coan-Meredith, LPC
• Susan Dooley Conaway

• All providers in Evansville, WI
• General Practice Dentistry in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2009; 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.