Abby L Smolcich, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

66612 Issued in WI

Practice address

W5282 Amy Ave
Appleton, WI 54915-7233

Phone

(920) 358-1900

Fax

(920) 358-1909

NPI assigned

Mar 27, 2015

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

Other names 1

• Abby L Callaway Former name

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: asmolcich2477@direct.thedacare.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Thedacare, Incorporated

  • Family Medicine Physician
  • New London, WI
  • NPI 1376656959
  Medicare reassignment NPD
• Thedacare, Incorporated

  • Counselor
  • Menasha, WI
  • NPI 1306959515
  NPD
• Medical College of Wisconsin Affiliated Hospitals

  • Student in an Organized Health Care Education/Training Program
  • Milwaukee, WI
  • NPI 1164365714
  NPD (past)
• Thedacare Medical Center - Berlin, Inc.

  • Critical Access Hospital
  • Berlin, WI
  • NPI 1760413777
  NPD (past)

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

{
    "created_epoch": "1427414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536796800000",
    "number": "1669866505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "122 E COLLEGE AVE",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549115794",
            "telephone_number": "920-996-3264",
            "fax_number": "920-830-5970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "W5282 AMY AVE",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549157233",
            "telephone_number": "920-358-1900",
            "fax_number": "920-358-1909"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "640 Deerwood Ave",
            "address_purpose": "LOCATION",
            "city": "Neenah",
            "state": "WI",
            "postal_code": "549567110",
            "country_code": "US",
            "telephone_number": "920-727-9982",
            "fax_number": "920-727-9983",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "999 N 92nd St",
            "address_2": "Suite 730",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532264875",
            "country_code": "US",
            "telephone_number": "414-266-6800",
            "fax_number": "414-337-7068",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2701 E Enterprise Ave",
            "address_purpose": "LOCATION",
            "city": "Appleton",
            "state": "WI",
            "postal_code": "549137729",
            "country_code": "US",
            "telephone_number": "920-954-2551",
            "fax_number": "920-954-0554",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMOLCICH",
        "first_name": "ABBY",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-27",
        "last_updated": "2018-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WI",
            "license": "66612",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ABBY",
            "last_name": "CALLAWAY",
            "middle_name": "L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Riley Smith, MSW
• Stephanie R Smith, PT
• Melissa M Smits, APNP
• Rachelle Smits, SAC-IT
• Shelby A Smits
• Denise Amy Smudde
• Margaret Elizabeth Sobal
• Daniel Soderlund, MD
• Sydni L Soderlund, MT-BC
• Sole 2 Soul, LLC

• Pediatrics Physician in Appleton, WI
• Providers in Appleton, WI by specialty
• Pediatrics Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.