Stephen D Reisner, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

0006377 Issued in WI

Practice address

120 1St St S
Ladysmith, WI 54848-1801

Phone

(715) 532-5606

Fax

(715) 532-9675

NPI assigned

Jan 25, 2013

Last updated

Jan 25, 2013By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Feb 5, 2016 through Feb 5, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• Dr Stephen Reisner Dentistry SC

  • Dentist
  • Ladysmith, WI
  • NPI 1811064231
  NPD (past) Authorized official
• Marshfield Clinic Inc

  dba Marshfield Clinic Florida Teleradiology/Telehealth

  • Clinic/Center
  • Marshfield, WI
  • NPI 1952347981
  NPD (past)

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

{
    "created_epoch": "1359072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1359072000000",
    "number": "1710225735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 1ST ST S",
            "city": "LADYSMITH",
            "state": "WI",
            "postal_code": "548481801",
            "telephone_number": "715-532-5606",
            "fax_number": "715-532-9675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 1ST ST S",
            "city": "LADYSMITH",
            "state": "WI",
            "postal_code": "548481801",
            "telephone_number": "715-532-5606",
            "fax_number": "715-532-9675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REISNER",
        "first_name": "STEPHEN",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-01-25",
        "last_updated": "2013-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WI",
            "license": "0006377",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "33489100",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sandy Radwanski, OTR, CMT
• Faly Rakotomahenina
• Richard W Rapp, D.O.
• Joanna Lynn Rasmussen, M.S.E.
• Susan Rae Reese, RDH
• Jason Russell Roe, PT,DPT
• James Michael Rubin, PHARM. D
• Nicole Rudack, MS,CCC-SLP
• Samantha Jo Runstrom, MD
• Rusk Co. Dept. of Health & Human Services

• Dentist in Ladysmith, WI
• Providers in Ladysmith, WI by specialty
• Dentist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2013; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.