Austin McMannes, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

1002077-15 Issued in WI

Practice address

115 E Thomas St
Rice Lake, WI 54868-3055

Phone

(715) 234-4636

Fax

(715) 234-2982

NPI assigned

May 30, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

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 and National Provider Directory roles.

• Northwoods Dentistry, Rice Lake LLC

  • Clinic/Center
  • Rice Lake, WI
  • NPI 1336624659
  NPD (past)

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

{
    "created_epoch": "1559174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559174400000",
    "number": "1770141236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2059 21 1/4 ST",
            "city": "RICE LAKE",
            "state": "WI",
            "postal_code": "548688809",
            "telephone_number": "651-238-4869"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 E THOMAS ST",
            "city": "RICE LAKE",
            "state": "WI",
            "postal_code": "548683055",
            "telephone_number": "715-234-4636",
            "fax_number": "715-234-2982"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCMANNES",
        "first_name": "AUSTIN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-05-30",
        "last_updated": "2019-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WI",
            "license": "1002077-15",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Raelene A Mattson, NP
• Rhonda Renee Mattson, CSAC
• Janice M McClelland
• Patricia A McGown
• Cheryl McMahon
• Kaileen McMickle, MS
• Ashley Jo McWalter, PA
• Medical Staffing Solutions, Inc
• Charles Kent Meng, OD
• Cheri Fox Messick, CCC-SLP

• Dentist in Rice Lake, WI
• Providers in Rice Lake, WI by specialty
• Dentist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2019; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.