Mary Elizabeth Doolittle, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

4891 Issued in WI

Practice address

2301 Chestnut Street
Wisconsin Rapids, WI 54494

Phone

(715) 424-2301

Fax

(715) 424-2309

NPI assigned

Oct 11, 2006

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

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

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1265760000000",
    "number": "1972692903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2301 CHESTNUT STREET",
            "city": "WISCONSIN RAPIDS",
            "state": "WI",
            "postal_code": "54494",
            "telephone_number": "715-424-2301",
            "fax_number": "715-424-2309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301 CHESTNUT STREET",
            "city": "WISCONSIN RAPIDS",
            "state": "WI",
            "postal_code": "54494",
            "telephone_number": "715-424-2301",
            "fax_number": "715-424-2309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOOLITTLE",
        "first_name": "MARY",
        "middle_name": "ELIZABETH",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-11",
        "last_updated": "2010-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WI",
            "license": "4891",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1223G0001X",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Todd Joseph Duellman, M.D.
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• Dentist in Wisconsin Rapids, WI
• Providers in Wisconsin Rapids, WI by specialty
• Dentist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2010; 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.