Individual provider Active NPI

Rachel M Steele, DDS

  • General Practice Dentistry
  • Black River Falls, WI
National Provider Identifier
1750503975
Registry record updated Feb 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
5718 Issued in WI
Practice address
716 W Adams St
Black River Falls, WI 54615-9108
Phone
(715) 284-9409
Fax
(715) 284-9167
NPI assigned
May 3, 2007
Last updated
Feb 1, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 5718 WI Primary

Addresses

Primary practice location

716 W Adams St
Black River Falls, WI 54615-9108

Mailing address

924 Alderman St
Tomah, WI 54660-3246
Phone (608) 317-1336

Other names 1

  • Dr. Rachel M Wruck Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150616002917 WI Order and Referring Only - DentistPractitioner - Dentist 0143531293

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5718WIMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Community Dental General Practice Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1359676800000",
    "number": "1750503975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "924 ALDERMAN ST",
            "city": "TOMAH",
            "state": "WI",
            "postal_code": "546603246",
            "telephone_number": "608-317-1336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "716 W ADAMS ST",
            "city": "BLACK RIVER FALLS",
            "state": "WI",
            "postal_code": "546159108",
            "telephone_number": "715-284-9409",
            "fax_number": "715-284-9167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEELE",
        "first_name": "RACHEL",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-03",
        "last_updated": "2013-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "5718",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RACHEL",
            "last_name": "WRUCK",
            "middle_name": "M",
            "prefix": "DR.",
            "credential": "DDS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Black River Falls, WI

Sources for this page

Verify at the official NPI Registry.