Kirk R Ritchie, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

4113015 Issued in WI

Practice address

5409 Everybodys Road
Forest County Potawatomi Health & Wellness Center
Crandon, WI 54520

Phone

(715) 478-4300

Fax

(715) 478-4490

NPI assigned

Aug 4, 2006

Last updated

Jul 8, 2007By the provider in NPPES

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

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in TX

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

Interoperability endpoints

• Direct secure messaging: kirk.ritchie.1@8439.direct.athenahealth.com

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

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1902814882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 396",
            "address_2": "5409 EVERYBODYS ROAD FOREST COUNTY POTAWATOMI HEALTH &",
            "city": "CRANDON",
            "state": "WI",
            "postal_code": "54520",
            "telephone_number": "715-478-4300",
            "fax_number": "715-478-4490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5409 EVERYBODYS ROAD",
            "address_2": "FOREST COUNTY POTAWATOMI HEALTH & WELLNESS CENTER",
            "city": "CRANDON",
            "state": "WI",
            "postal_code": "54520",
            "telephone_number": "715-478-4300",
            "fax_number": "715-478-4490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RITCHIE",
        "first_name": "KIRK",
        "middle_name": "R",
        "name_prefix": "Mr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WI",
            "license": "4113015",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "33704300",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SECURITY HEALTH PLAN",
            "identifier": "74434",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• William R Pierre, OD TPA
• Gary M Pusateri, MD
• Robert Lee Quade, RN
• Kristen Radloff, FNP, APNP
• Katherine Richlen, RD
• Christina Gabriella Ritzer, RDN LD CD
• Melinda M Roth, PMHNP
• Jacklin A Sailo, FNP
• Bonnie M Samuelson, M.D.
• Samantha Lynn Scheel, DMD

• Dentist in Crandon, WI
• Providers in Crandon, WI by specialty
• Dentist in Wisconsin

• 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.

Verify at the official NPI Registry.