DR. DERRICK ROBSON SIEBERT (NPI# 1063674224) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1063674224 |
Entity Type | Individual |
Full Name | DR. DERRICK ROBSON SIEBERT |
Credential | M.D. |
Practice Address |
333 Pine Ridge Blvd Wausau WI 54401-4120 |
Mailing Address |
Po Box 1324 Wausau WI 54402-1324 |
Practice Telephone | 7158472283 |
Mailing Telephone | 4145591273 |
Enumeration Date | 2008-06-30 |
Last Update Date | 2014-06-23 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
61877 - 20 | WI | Allopathic & Osteopathic Physicians |
N | 2085R0204X |
Radiology Specialization: Vascular & Interventional Radiology |
61877 - 20 | WI | Allopathic & Osteopathic Physicians |
Street Address |
333 PINE RIDGE BLVD |
City | WAUSAU |
State | WI |
Zip Code | 54401-4120 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1558363986 | Aspirus Wausau Hospital, Inc | General Acute Care Hospital | 333 Pine Ridge Blvd, Wausau, WI 54401-4120 | 2005-08-15 |
1902415789 | John Hupp II | Registered Nurse | 333 Pine Ridge Blvd, Wausau, WI 54401-4102 | 2020-07-28 |
1720600240 | Jennifer Scharenbrock | Physical Therapist | 333 Pine Ridge Blvd, Wausau, WI 54401-4102 | 2020-05-07 |
1467009282 | Anson Mcquigg | Nurse Anesthetist, Certified Registered | 333 Pine Ridge Blvd, Wausau, WI 54401-4102 | 2019-08-26 |
1447807086 | Kelly Jonathon Douck | Nurse Anesthetist, Certified Registered | 333 Pine Ridge Blvd, Wausau, WI 54401-4102 | 2019-08-19 |
1699329102 | Madeline Erickson | Occupational Therapist | 333 Pine Ridge Blvd, Wausau, WI 54401-4187 | 2019-08-01 |
1194384198 | Emily Morgan Meyer | Occupational Therapist | 333 Pine Ridge Blvd, Wausau, WI 54401-4102 | 2019-06-12 |
1659937738 | Breanna Zajichek | Physician Assistant | 333 Pine Ridge Blvd, Wausau, WI 54401-4102 | 2019-05-14 |
1336703677 | Sophia Frances Andera-cato | Physician Assistant | 333 Pine Ridge Blvd, Wausau, WI 54401-4187 | 2019-04-23 |
1073096681 | Beth Brinkman | Occupational Therapist | 333 Pine Ridge Blvd, Wausau, WI 54401-4102 | 2018-09-10 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1164031464 | Central Wisconsin Endodontic Specialists LLC | Dentist | 2606 Stewart Avenue, #102, Wausau, WI 54401 | 2020-07-23 |
1376161976 | Family Foot and Ankle Clinic LLC | Podiatrist | 1901 Westwood Boulevard, Wausau, WI 54401 | 2020-07-09 |
1336701895 | Amy Kluetz | Counselor | 3000 Westhill Drive, Suite 100, Wausau, WI 54401 | 2019-07-05 |
1437640877 | Joseph T Fitz | Student in an Organized Health Care Education/Training Program | Aspirus Wausau Family Medicine, 425 Wind Ridge Drive, Wausau, WI 54401 | 2018-05-22 |
1699293241 | Amanda Nedd | Dietitian, Registered | 425 Pine Ridge Boulevard Suite 220 C, Wausau, WI 54401 | 2017-09-05 |
1396287447 | Dee Cha | Nurse Anesthetist, Certified Registered | 4851 Rachel Ln Apt 5, Wausau, WI 54401 | 2016-11-07 |
1013389618 | Grace Lutheran Foundation Inc | Skilled Nursing Facility | 2727 Plaza Dr., Wausau, WI 54401 | 2015-10-22 |
1881091163 | Judy Lao | Dental Hygienist | 413 North 17th Avenue, Wausau, WI 54401 | 2014-12-02 |
1295012011 | Allison Waraksa | Pharmacist | 504 S. 17th Ave, Wausau, WI 54401 | 2011-11-08 |
1881974053 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 504 S 17th Ave, Wausau, WI 54401 | 2011-08-19 |
Find all providers in zip 54401 |
Taxonomy Code | 2085R0202X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Radiology |
Specialization | Diagnostic Radiology |
A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1114152493 | Jacob H. Martens | Radiology | 414 Kent St, Wausau, WI 54403-6927 | 2009-05-15 |
1376555839 | Stephen B Stine | Radiology | 3200 Westhill Dr Ste 210, Wausau, WI 54401-4707 | 2006-08-13 |
1750700688 | Endel Aleksander Sorra II | Radiology | 333 Pine Ridge Blvd, Aspirus Hospital, Wausau, WI 54401 | 2014-04-08 |
1780014407 | Aspirus Wausau Hospital, Inc | Radiology | 3200 Westhill Dr, Wausau, WI 54401-4705 | 2013-11-15 |
1952490054 | Aspirus Inc | Radiology | 3200 Westhill Dr, Wausau, WI 54401-4705 | 2006-10-12 |
1306946025 | Rosita S Go | Radiology | 2727 Plaza Dr, Wausau, WI 54401-4129 | 2006-09-23 |
1417057142 | Mark W De Clute | Radiology | 2727 Plaza Drive, Wausau, WI 54401 | 2006-09-23 |
1922118512 | Alan C Williams | Radiology | 2727 Plaza Drive, Wausau, WI 54401 | 2006-08-30 |
1255343703 | Vinay D Luthra | Radiology | 3200 Westhill Dr Ste 210, Wausau, WI 54401-4707 | 2006-08-13 |
1992714810 | John R Sorenson | Radiology | 3200 Westhill Dr, Suite 210, Wausau, WI 54401-4705 | 2006-08-07 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.