Active NPI
Frank Mraz, MD
- Family Medicine Physician
- Crandon, WI
National Provider Identifier
1720033186
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 44456
- Practice address
- 5409 Everybody'S Road
Crandon, WI 54520 - Phone
- (715) 478-4328
- Fax
- (715) 478-4496
- NPI assigned
- May 24, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 44456 | WI | Primary |
Addresses
Primary practice location
5409 Everybody'S Road
Crandon, WI 54520
Mailing address
PO Box 396
Crandon, WI 54520-0396
Phone (715) 478-4328
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 34196500 | Medicaid | WI |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 44456 | WI | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148428800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1238544000000",
"number": "1720033186",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 396",
"city": "CRANDON",
"state": "WI",
"postal_code": "545200396",
"telephone_number": "715-478-4328",
"fax_number": "715-478-4496"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5409 EVERYBODY'S ROAD",
"city": "CRANDON",
"state": "WI",
"postal_code": "54520",
"telephone_number": "715-478-4328",
"fax_number": "715-478-4496"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MRAZ",
"first_name": "FRANK",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-24",
"last_updated": "2009-04-01",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "WI",
"license": "44456",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "34196500",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Crandon, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.