Individual provider Active NPI

Jonathon A Forncrook, DO

  • Internal Medicine Physician
  • Marshfield, WI
National Provider Identifier
1780784629
Registry record updated Apr 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
20A 10861 Issued in CA
Practice address
1000 N Oak Ave
1F2
Marshfield, WI 54449-6733
Phone
(715) 389-3141
NPI assigned
Sep 22, 2006
Last updated
Apr 22, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 20A 10861 CA Primary
Internal Medicine Physician 207R00000X 38920 WI
Pediatrics Physician 208000000X 20A 10861 CA
Pediatrics Physician 208000000X 38920 WI

Addresses

Primary practice location

1000 N Oak Ave
1F2
Marshfield, WI 54449-6733

Mailing address

1000 N Oak Ave
Marshfield, WI 54449-5702
Phone (157) 389-3141

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20031205000476 WI Practitioner - Internal MedicinePractitioner - Pediatric Medicine 2769387349 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
38920WIMDInternal Medicine Physician
20A 10861CAMDPediatrics Physician
10861CAMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
MCHS Hospitals Inc Internal Medicine CurrentSince Mar 1, 2018 Accepting new patients
MCHS Hospitals Inc CurrentSince Mar 1, 2018 Accepting new patients
Marshfield Clinic Inc CurrentSince Nov 14, 2016 Accepting new patients

Locations

1000 Starr Ave
Eau Claire, WI 54703
Phone (715) 858-4850

3501 Golf Rd
Eau Claire, WI 54701
Phone (715) 858-4200

1000 N Oak Ave
Marshfield, WI 54449
Phone (715) 387-5111

1000 N Oak Ave
#1F2
Marshfield, WI 54449
Phone (715) 389-3141

Interoperability endpoints

  • Direct secure messaging: jonathon.forncrook@marshfieldclinichealthsystem.cernerdirect.com

Organizations & group practices 3

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": "1158883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713744000000",
    "number": "1780784629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 N OAK AVE",
            "city": "MARSHFIELD",
            "state": "WI",
            "postal_code": "544495702",
            "telephone_number": "157-389-3141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 N OAK AVE",
            "address_2": "1F2",
            "city": "MARSHFIELD",
            "state": "WI",
            "postal_code": "544496733",
            "telephone_number": "715-389-3141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORNCROOK",
        "first_name": "JONATHON",
        "middle_name": "A",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-22",
        "last_updated": "2024-04-22",
        "certification_date": "2024-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "20A 10861",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WI",
            "license": "38920",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "20A 10861",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WI",
            "license": "38920",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marshfield, WI

Sources for this page

Verify at the official NPI Registry.