Individual provider Active NPI

Athena Daniolos, MD

  • Dermatology Physician
  • Madison, WI
National Provider Identifier
1962461194
Registry record updated Feb 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
32435-20 Issued in WI
Practice address
752 N High Point Rd
Madison, WI 53717-2236
Phone
(608) 824-4000
Fax
(608) 824-4945
NPI assigned
Mar 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 32435-20 WI Primary

Addresses

Primary practice location

752 N High Point Rd
Madison, WI 53717-2236

Mailing address

752 N High Point Rd
Madison, WI 53717-2236
Phone (608) 824-4000

Other identifiers 1

IdentifierTypeStateIssuer
61203OtherWIDEAN HEALTH INSURANCE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1142553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424044800000",
    "number": "1962461194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "752 N HIGH POINT RD",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537172236",
            "telephone_number": "608-824-4000",
            "fax_number": "608-824-4945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "752 N HIGH POINT RD",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537172236",
            "telephone_number": "608-824-4000",
            "fax_number": "608-824-4945"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANIOLOS",
        "first_name": "ATHENA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-17",
        "last_updated": "2015-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "WI",
            "license": "32435-20",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEAN HEALTH INSURANCE",
            "identifier": "61203",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.