Active NPI
Stephen B Webster, MD
- Dermatology Physician
- Onalaska, WI
National Provider Identifier
1750385498
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- 17788
- Practice address
- 3111 Gundersen Dr
Onalaska, WI 54650-8447 - Phone
- (608) 775-2625
- NPI assigned
- Jun 10, 2005
- 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 |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | 17788 | WI | Primary |
Addresses
Primary practice location
3111 Gundersen Dr
Onalaska, WI 54650-8447
Mailing address
3111 Gundersen Dr
Onalaska, WI 54650-8447
Phone (608) 775-2625
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 31116900 | 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 |
|---|---|---|---|
| 17788 | WI | MD | Dermatology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1118361600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1488153600000",
"number": "1750385498",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3111 GUNDERSEN DR",
"city": "ONALASKA",
"state": "WI",
"postal_code": "546508447",
"telephone_number": "608-775-2625"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3111 GUNDERSEN DR",
"city": "ONALASKA",
"state": "WI",
"postal_code": "546508447",
"telephone_number": "608-775-2625"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WEBSTER",
"first_name": "STEPHEN",
"middle_name": "B",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-06-10",
"last_updated": "2017-02-27",
"status": "A"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "WI",
"license": "17788",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "31116900",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Onalaska, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.