Active NPI
John B Waldron, MD
- Family Medicine Physician
- Rice Lake, WI
National Provider Identifier
1639270408
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 25738
- Practice address
- 1700 W Stout St
Rice Lake, WI 54868-5000 - Phone
- (715) 236-8100
- NPI assigned
- Sep 26, 2006
- Last updated
- Jan 31, 2013
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 25738 | WI | Primary |
Addresses
Primary practice location
1700 W Stout St
Rice Lake, WI 54868-5000
Mailing address
1000 N Oak Ave
Marshfield, WI 54449-5703
Phone (715) 387-5511
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 Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25738 | WI | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159228800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1359590400000",
"number": "1639270408",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1000 N OAK AVE",
"city": "MARSHFIELD",
"state": "WI",
"postal_code": "544495703",
"telephone_number": "715-387-5511"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1700 W STOUT ST",
"city": "RICE LAKE",
"state": "WI",
"postal_code": "548685000",
"telephone_number": "715-236-8100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALDRON",
"first_name": "JOHN",
"middle_name": "B",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-26",
"last_updated": "2013-01-31",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "WI",
"license": "25738",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Rice Lake, WI
- Mark Richard Vrieze, P.T.
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- Wal-Mart Stores East, LP (Vision Center 30-1446)
- Wal-Mart Stores East, LP (Vision Center 30-1446)
- Marissa Lorena Walczak, FNP-BC
- Walgreen Co (Walgreens #11860)
- Amanda Waller
- Carrie Wamhoff
- Mark C. Waters, D.D.S.
- Weber Chiropractic LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.