Active NPI
Debra J Ewing, DO
- Family Medicine Physician
- Janesville, WI
National Provider Identifier
1619984127
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 46938-021
- Practice address
- 3524 E Milwaukee St
Janesville, WI 53546-1626 - Phone
- (608) 756-7100
- Fax
- (608) 756-4700
- NPI assigned
- Aug 1, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 46938-021 | WI | Primary |
| Family Medicine Physician | 207Q00000X | 13430 | CA | |
| Family Medicine Physician | 207Q00000X | 036126087 | IN | |
| Family Medicine Physician | 207Q00000X | 02004337A | IN |
Addresses
Primary practice location
3524 E Milwaukee St
Janesville, WI 53546-1626
Mailing address
3524 E Milwaukee St
Janesville, WI 53546-1626
Phone (608) 756-7100
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| EWINGDEB | Other | WI | MERCYCARE INSURANCE |
| 1619984127 | Other | WI | BCBSWI |
| 1619984127 | Medicaid | WI | |
| 0361260872 | Medicaid | IL |
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 Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 02004337A | IN | MD | Family Medicine Physician |
| 036126087 | IN | MD | Family Medicine Physician |
| 46938-021 | WI | MD | Family Medicine Physician |
| 13430 | CA | MD | Certified Respiratory Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154390400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1463529600000",
"number": "1619984127",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3524 E MILWAUKEE ST",
"city": "JANESVILLE",
"state": "WI",
"postal_code": "535461626",
"telephone_number": "608-756-7100",
"fax_number": "608-756-4700"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3524 E MILWAUKEE ST",
"city": "JANESVILLE",
"state": "WI",
"postal_code": "535461626",
"telephone_number": "608-756-7100",
"fax_number": "608-756-4700"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EWING",
"first_name": "DEBRA",
"middle_name": "J",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-01",
"last_updated": "2016-05-18",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "WI",
"license": "46938-021",
"primary": true
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "CA",
"license": "13430",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IN",
"license": "036126087",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IN",
"license": "02004337A",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MERCYCARE INSURANCE",
"identifier": "EWINGDEB",
"state": "WI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBSWI",
"identifier": "1619984127",
"state": "WI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1619984127",
"state": "WI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0361260872",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Janesville, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.