Individual provider Active NPI

Donald M Muth, MD

  • Internal Medicine Physician
  • West Bend, WI
National Provider Identifier
1992812325
Registry record updated Apr 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
15761 Issued in WI
Practice address
908 W Washington St
West Bend, WI 53095-2430
Phone
(262) 334-8339
Fax
(262) 306-7717
NPI assigned
Aug 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Worker 172V00000X 15761 WI
Internal Medicine Physician 207R00000X 15761 WI Primary

Addresses

Primary practice location

908 W Washington St
West Bend, WI 53095-2430

Mailing address

908 W Washington St
West Bend, WI 53095-2430
Phone (262) 334-8339

Other identifiers 1

IdentifierTypeStateIssuer
31209100MedicaidWI

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

State licenses

LicenseStateTypeSpecialty
15761WIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Froedtert &the Medical College of Wisconsin Community Physicians, Inc. Internal Medicine Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1156291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555977600000",
    "number": "1992812325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "908 W WASHINGTON ST",
            "city": "WEST BEND",
            "state": "WI",
            "postal_code": "530952430",
            "telephone_number": "262-334-8339",
            "fax_number": "262-306-7717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "908 W WASHINGTON ST",
            "city": "WEST BEND",
            "state": "WI",
            "postal_code": "530952430",
            "telephone_number": "262-334-8339",
            "fax_number": "262-306-7717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUTH",
        "first_name": "DONALD",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-23",
        "last_updated": "2019-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "WI",
            "license": "15761",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WI",
            "license": "15761",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "31209100",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Bend, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2019; 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.