Individual provider Active NPI

Rhonda M Dodd, LPN

  • Licensed Practical Nurse
  • Wausau, WI
National Provider Identifier
1679611107
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
Practice address
209B W Washington St
Wausau, WI 54403-5443
Phone
(715) 845-3637
NPI assigned
Feb 5, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X WI Primary

Addresses

Primary practice location

209B W Washington St
Wausau, WI 54403-5443

Mailing address

PO Box 171
311 Kuhlmann Ave.
Hatley, WI 54440-0171
Phone (715) 297-2719

Other identifiers 1

IdentifierTypeStateIssuer
42024500MedicaidWI

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

LicenseStateTypeSpecialty
303743-031WIMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1170633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1679611107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 171",
            "address_2": "311 KUHLMANN AVE.",
            "city": "HATLEY",
            "state": "WI",
            "postal_code": "544400171",
            "telephone_number": "715-297-2719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209B W WASHINGTON ST",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544035443",
            "telephone_number": "715-845-3637"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DODD",
        "first_name": "RHONDA",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-05",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "WI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "42024500",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wausau, WI

Sources for this page

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

Verify at the official NPI Registry.