Individual provider Active NPI

Mary F McDonald, MD

  • Gastroenterology Physician
  • Oshkosh, WI
National Provider Identifier
1699789396
Registry record updated Dec 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
28027020 Issued in WI
Practice address
2700 W 9TH Ave
Suite 300
Oshkosh, WI 54904-7247
Phone
(920) 223-0490
NPI assigned
Jul 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 28027020 WI Primary
Hepatology Physician 207RI0008X 28027020 WI

Addresses

Primary practice location

2700 W 9TH Ave
Suite 300
Oshkosh, WI 54904-7247

Mailing address

3420 Jackson St
Suite E
Oshkosh, WI 54901-8144
Phone (920) 426-2211

Other identifiers 1

IdentifierTypeStateIssuer
30757700MedicaidWI

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

LicenseStateTypeSpecialty
28027020WIMDHepatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Gastrointestinal Specialists SC Gastroenterology PastSince Jan 1, 2007 Accepting new patients
Psychiatric Consultants SC Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1228262400000",
    "number": "1699789396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3420 JACKSON ST",
            "address_2": "SUITE E",
            "city": "OSHKOSH",
            "state": "WI",
            "postal_code": "549018144",
            "telephone_number": "920-426-2211",
            "fax_number": "920-426-2231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 W 9TH AVE",
            "address_2": "SUITE 300",
            "city": "OSHKOSH",
            "state": "WI",
            "postal_code": "549047247",
            "telephone_number": "920-223-0490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDONALD",
        "first_name": "MARY",
        "middle_name": "F",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-28",
        "last_updated": "2008-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "WI",
            "license": "28027020",
            "primary": true
        },
        {
            "code": "207RI0008X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hepatology",
            "state": "WI",
            "license": "28027020",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30757700",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oshkosh, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2008; 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.