Active NPI
Paul S Shoberg, DO
- Dentist
- Appleton, WI
National Provider Identifier
1851302186
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 3939
- Practice address
- 230 N Morrison St
Appleton, WI 54911-5459 - Phone
- (920) 733-4555
- Fax
- (920) 733-6734
- NPI assigned
- Aug 11, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Dentist | 122300000X | 3939 | WI | Primary |
Addresses
Primary practice location
230 N Morrison St
Appleton, WI 54911-5459
Mailing address
8736 Pioneer Rd
Larsen, WI 54947-9705
Phone (920) 733-4555
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155254400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1851302186",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8736 PIONEER RD",
"city": "LARSEN",
"state": "WI",
"postal_code": "549479705",
"telephone_number": "920-733-4555",
"fax_number": "920-733-6734"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "230 N MORRISON ST",
"city": "APPLETON",
"state": "WI",
"postal_code": "549115459",
"telephone_number": "920-733-4555",
"fax_number": "920-733-6734"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHOBERG",
"first_name": "PAUL",
"middle_name": "S",
"name_prefix": "Dr.",
"credential": "DO",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-11",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "WI",
"license": "3939",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Appleton, WI
- Curtis P Sheldon, CRNA, MS APNA
- Kathleen J Sheridan, APNP
- Sherman Counseling Management, S.C. (Sherman Counseling Management)
- David Shinkunas, DO
- Stephanie Shirey
- Cheryl Lynn Shockey, R.D., M.S.
- Shopko Institutional Care Services Co LLC (Shopko RxCare)
- Shopko Stores Operating Co LLC (ShopKo Optical 504)
- Shopko Stores Operating Co LLC (ShopKo Pharmacy 505)
- Shopko Stores Operating Co LLC (ShopKo Pharmacy 504)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.