Active NPI
James Stephen Wommack, D.D.S.
- Dentist
- Madison, WI
National Provider Identifier
1659589927
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 5341-015
- Practice address
- 115 W Doty St
Madison, WI 53703-3276 - Phone
- (608) 266-5942
- NPI assigned
- May 19, 2007
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 5341-015 | WI | Primary |
| Dentist | 122300000X | 10437 | MN | |
| Dentist | 122300000X | 14145 | TX |
Addresses
Primary practice location
115 W Doty St
Madison, WI 53703-3276
Mailing address
8540 Greenway Blvd
#103
Middleton, WI 53562-4700
Phone (608) 831-1282
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14145 | TX | MD | Addiction (Substance Use Disorder) Counselor |
| 10437 | MN | MD | Dentist |
| 5341-015 | WI | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179532800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1659589927",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8540 GREENWAY BLVD",
"address_2": "#103",
"city": "MIDDLETON",
"state": "WI",
"postal_code": "535624700",
"telephone_number": "608-831-1282"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "115 W DOTY ST",
"city": "MADISON",
"state": "WI",
"postal_code": "537033276",
"telephone_number": "608-266-5942"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOMMACK",
"first_name": "JAMES",
"middle_name": "STEPHEN",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-05-19",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "WI",
"license": "5341-015",
"primary": true
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MN",
"license": "10437",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "TX",
"license": "14145",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Madison, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.