MATTHEW ANTHONY HETTENBACH (NPI# 1003430729) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003430729 |
| Entity Type | Individual |
| Full Name | MATTHEW ANTHONY HETTENBACH |
| Credential | PMHNP |
| Practice Address |
1244 Wisconsin Ave Racine WI 53403-1987 |
| Mailing Address |
2019 Saint Clair St Racine WI 53402-4763 |
| Practice Telephone | 2626872956 |
| Mailing Telephone | 2629954662 |
| Enumeration Date | 2020-05-29 |
| Last Update Date | 2020-05-29 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
10089 | WI | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1244 WISCONSIN AVE |
| City | RACINE |
| State | WI |
| Zip Code | 53403-1987 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043207806 | William James Bjerregaard | Psychiatry & Neurology | 1244 Wisconsin Ave, Suite 303, Racine, WI 53403-1987 | 2005-10-05 |
| 1972810927 | Aaron Gubi | Student in an Organized Health Care Education/Training Program | 1244 Wisconsin Ave, Racine, WI 53403-1987 | 2010-09-10 |
| 1679720312 | Susan J Perez | Physician Assistant | 1244 Wisconsin Ave, Racine, WI 53403-1987 | 2008-08-25 |
| 1609065598 | Daniel J Moyer | Pharmacist | 1244 Wisconsin Ave, Racine, WI 53403-1987 | 2007-10-17 |
| 1225227283 | Rebecca Hamilton | Pharmacist | 1244 Wisconsin Ave, Racine, WI 53403-1987 | 2007-10-16 |
| 1154510188 | Robert R Umhoefer | Pharmacist | 1244 Wisconsin Ave, Racine, WI 53403-1987 | 2007-10-16 |
| 1740479708 | Susan M Skantz | Pharmacist | 1244 Wisconsin Ave, Racine, WI 53403-1987 | 2007-10-16 |
| 1215139860 | Nancy Ruth Maczka | Nurse Practitioner | 1244 Wisconsin Ave, Suite 300, Racine, WI 53403-1987 | 2007-06-05 |
| 1790878122 | Ascension All Saints Hospital, Inc | Pharmacy | 1244 Wisconsin Ave, Racine, WI 53403-1987 | 2006-09-30 |
| 1063489300 | Troy Robert Gauger | Specialist/Technologist | 1244 Wisconsin Ave, Racine, WI 53403-1987 | 2006-03-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124676259 | Quality Care LLC | Clinic/Center | 2051 Mead St, Racine, WI 53403 | 2019-09-02 |
| 1073999355 | Wisconsin Lutheran Child & Family Service, Inc. | Social Worker | 6150 Taylor Avenue, Racine, WI 53403 | 2015-08-10 |
| 1457780496 | Pheynell Branch | Counselor | 1650 Wasington Ave, Racine, WI 53403 | 2013-11-08 |
| 1811278054 | Michelle Gloria Parisot | Psychologist | 1320 Wisconsin Ave., Racine, WI 53403 | 2011-09-01 |
| 1720372022 | Katie Hagen | Social Worker | 1717 Taylor Avenue, Racine, WI 53403 | 2011-06-03 |
| 1043431570 | Rita S Harris | Physical Therapy Assistant | Lakeshore Manor 1320 Wisconsin Avenue, Racine, WI 53403 | 2007-05-01 |
| 1336281336 | Linda J Hockensmith | Occupational Therapist | 4214 Sheridan Road, Racine, WI 53403 | 2007-02-13 |
| 1851447387 | Richard John Kemper | Dentist | 1509 Washington Ave, Racine, WI 53403 | 2007-01-26 |
| 1689760332 | Lester Leslie Higgenbottom | Counselor | 1820 Arlington Ave, Racine, WI 53403 | 2006-10-04 |
| 1114942315 | Access Medical Center, LLC | Clinic/Center | 4216 Old Green Bay Rd, Racine, WI 53403 | 2006-07-12 |
| Find all providers in zip 53403 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215139860 | Nancy Ruth Maczka | Nurse Practitioner | 1244 Wisconsin Ave, Suite 300, Racine, WI 53403-1987 | 2007-06-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003422726 | Wisconsin Healthcare Family Practices and Behavioral Services LLC | Nurse Practitioner | 10721 W Capitol Dr Ste G103, Wauwatosa, WI 53222-1210 | 2020-09-17 |
| 1689292856 | Julianne Margaret John | Nurse Practitioner | 3237 S 16th St Ste 310, Milwaukee, WI 53215-4526 | 2020-07-13 |
| 1356968002 | Marisa Hiley | Nurse Practitioner | W129 N7055 Northfield Drive, Menomonee Falls, WI 53051 | 2020-06-29 |
| 1932726700 | Lauren Marie Skemp | Nurse Practitioner | 1960 Hyview Rd, Cuba City, WI 53807-9718 | 2020-06-28 |
| 1235779240 | Conscious Practice, LLC | Nurse Practitioner | 119 19th St N, La Crosse, WI 54601-3724 | 2020-01-08 |
| 1073152161 | Stephanie L Ruskell | Nurse Practitioner | 3805 Spring St Ste 240, Mount Pleasant, WI 53405-1667 | 2020-01-06 |
| 1558924811 | Sarah Kathryn Garven | Nurse Practitioner | 5000 West National Ave Rm 3119, Milwaukee, WI 53295-1000 | 2019-04-22 |
| 1104394535 | Therese Ann Alm | Nurse Practitioner | 383 Williamstowne Ste 101, Delafield, WI 53018-2332 | 2018-11-03 |
| 1477079242 | Aeron Rachel Adams | Nurse Practitioner | W10237 Lake Emily Rd, Fox Lake, WI 53933 | 2017-08-14 |
| 1396140398 | Monica Gorski | Nurse Practitioner | 505 King St Ste 218, La Crosse, WI 54601-4289 | 2014-11-03 |
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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.