Marylyn S Ranta, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

26860 Issued in WI

Practice address

4855 S Moorland Rd
Suite 150
New Berlin, WI 53151-7401

Phone

(414) 425-5660

Fax

(414) 425-9803

NPI assigned

Sep 13, 2005

Sex

Female

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 1

Other names 1

• Marylyn S Cleary Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1126569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1252886400000",
    "number": "1972598209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4855 S MOORLAND RD",
            "address_2": "SUITE 150",
            "city": "NEW BERLIN",
            "state": "WI",
            "postal_code": "531517401",
            "telephone_number": "414-425-5660",
            "fax_number": "414-425-9803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4855 S MOORLAND RD",
            "address_2": "SUITE 150",
            "city": "NEW BERLIN",
            "state": "WI",
            "postal_code": "531517401",
            "telephone_number": "414-425-5660",
            "fax_number": "414-425-9803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RANTA",
        "first_name": "MARYLYN",
        "middle_name": "S",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-13",
        "last_updated": "2009-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WI",
            "license": "26860",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30686200",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARYLYN",
            "last_name": "CLEARY",
            "middle_name": "S",
            "credential": "M.S.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Karla Michelle Quinones, AUD
• Jamie Lee Radant, LPC
• John Patrick Rader, LCSW
• Derek Dale Raese
• Lauren Ramsey
• Stephanie M. Rasmussen, CF-SLP
• David Campbell Raupp
• Meaghan Reaney, DO
• Rachel Reardon, FNP-BC
• Rachel Rebholz, RN, IBCLC

• Pediatrics Physician in New Berlin, WI
• Providers in New Berlin, WI by specialty
• Pediatrics Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2009; 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.