Active NPI
Katie Johannah Livingston, MD
- Radiation Oncology Physician
- Marinette, WI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Radiation Oncology Physician
- License
- 70902
- Practice address
- 3003 University Dr
Marinette, WI 54143-4110 - Phone
- (715) 735-8015
- Fax
- (715) 732-8215
- NPI assigned
- Apr 2, 2017
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Radiation Oncology Physician | 2085R0001X | 70902 | WI | Primary |
Addresses
Primary practice location
3003 University Dr
Marinette, WI 54143-4110
Mailing address
11516 N Port Washington Rd Ste 107
Mequon, WI 53092-3478
Phone (262) 241-5040
Other practice location 1
2845 Greenbrier Rd
Green Bay, WI 54311-6519
Phone (920) 288-4160
Other names 1
- Katie Johannah Dobberpuhl
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Radiation Oncology
- Education
- Medical College of Wisconsin, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1222 N 23Rd St
Sheboygan, WI 53081-3171
Phone (920) 457-6800
1506 S Oneida St
Appleton, WI 54915-1305
Phone (920) 831-8900
2700 W 9TH Ave
Suite 11
Oshkosh, WI 54904-7863
Phone (920) 831-8900
2845 Greenbrier Rd
Green Bay, WI 54311-6519
Phone (920) 288-4160
2900 W Oklahoma Ave
Milwaukee, WI 53215-4330
Phone (414) 649-6420
3003 University Dr
Marinette, WI 54143-4110
Phone (715) 735-8015
5300 Memorial Dr
Two Rivers, WI 54241-3923
Phone (920) 793-7349
855 N Westhaven Dr
Oshkosh, WI 54904-7668
Phone (920) 456-7900
Hospital & facility affiliations
- Aurora Baycare Medical Ctr
- Aurora Medical Center Bay Area
- Aurora Medical Ctr Oshkosh
- Aurora Medical Ctr Manitowoc County
- Ascension NE Wisconsin - St Elizabeth Campus
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 70902 | WI | MD | Radiation Oncology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Radiation Oncology Associates, LTD | Radiation Oncology | Current | Accepting new patients |
Locations
1506 S Oneida St
Appleton, WI 54915
Phone (920) 730-4950
2845 Greenbrier Rd
Green Bay, WI 54311
Phone (920) 288-3388
3003 University Dr
Marinette, WI 54143
Phone (715) 735-4200
11516 N Port Washington Rd
Ste 107
Mequon, WI 53092
Phone (262) 241-5040
2900 W Oklahoma Ave
Milwaukee, WI 53215
Phone (414) 385-2590
855 N Westhaven Dr
Oshkosh, WI 54904
Phone (920) 451-5643
5300 Memorial Dr
Ste 104
Two Rivers, WI 54241
Phone (920) 793-7349
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 and National Provider Directory roles.
-
- Radiation Oncology Physician
- Milwaukee, WI
- NPI 1932154754
Hospital & facility affiliations 8
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Appleton, WI
- NPI 1407803638
-
- General Acute Care Hospital
- Two Rivers, WI
- NPI 1477508687
-
- General Acute Care Hospital
- Marinette, WI
- NPI 1043397177
-
- Clinical Medical Laboratory
- Marinette, WI
- NPI 1083791115
Hospital
-
- General Acute Care Hospital
- Oshkosh, WI
- NPI 1275578064
-
- General Acute Care Hospital
- Green Bay, WI
- NPI 1255387726
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1491091200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1661126400000",
"number": "1861924482",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11516 N PORT WASHINGTON RD STE 107",
"city": "MEQUON",
"state": "WI",
"postal_code": "530923478",
"telephone_number": "262-241-5040",
"fax_number": "414-241-5241"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3003 UNIVERSITY DR",
"city": "MARINETTE",
"state": "WI",
"postal_code": "541434110",
"telephone_number": "715-735-8015",
"fax_number": "715-732-8215"
}
],
"practiceLocations": [
{
"address_1": "2845 Greenbrier Rd",
"address_purpose": "LOCATION",
"city": "Green Bay",
"state": "WI",
"postal_code": "543116519",
"country_code": "US",
"telephone_number": "920-288-4160",
"fax_number": "920-288-4162",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LIVINGSTON",
"first_name": "KATIE",
"middle_name": "JOHANNAH",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-04-02",
"last_updated": "2022-08-22",
"certification_date": "2022-08-22",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0001X",
"taxonomy_group": "",
"desc": "Radiology, Radiation Oncology",
"state": "WI",
"license": "70902",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "KATIE",
"last_name": "DOBBERPUHL",
"middle_name": "JOHANNAH",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Marinette, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2022; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.