Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Timothy J Sanner

Individual provider Physician Assistant · NPI 1093309569

Timothy J Sanner is a Physician Assistant in Appleton, Wisconsin. Qualified in 2021, 5 years ago. Practices with Ascension Medical Group-Fox Valley Wisconsin, Inc, a 260-clinician group and accepts Medicare assignment. Licensed in Wisconsin.

Years since qualifying
5
Licensed in
WI
In the registry since
2021
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Practice location Address checks out

701 S Nicolet Rd
Appleton, WI 54914-8273
Phone: (414) 288-5688
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 5468-23 (WI)

Record details

NPI number1093309569
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedFebruary 25, 2021
Last updated in NPPESJuly 6, 2021
Certification dateJuly 6, 2021
Mailing address701 S Nicolet Rd, Appleton, WI 54914-8273

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Ascension Medical Group-Fox Valley Wisconsin, Inc — 260 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

Other providers in Appleton