DR. CULLEN TIMOTHY KEHOE (NPI# 1013166925) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013166925 |
| Entity Type | Individual |
| Full Name | DR. CULLEN TIMOTHY KEHOE |
| Credential | DO |
| Practice Address |
N2950 State Road 67 Lake Geneva WI 53147-2655 |
| Practice Telephone | 2622454990 |
| Practice Fax Number | 2622452248 |
| Mailing Telephone | 2622454990 |
| Mailing Fax Number | 2622452248 |
| Enumeration Date | 2008-09-16 |
| Last Update Date | 2016-03-23 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207P00000X | Emergency Medicine | 53435-21 | WI | Allopathic & Osteopathic Physicians |
| N | 207P00000X | Emergency Medicine | 036122047 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | BCBSWI | 1013166925 | 01 |
| WI | 1013166925 | 05 | |
| WI | MERCYCARE INSURANCE | KEHOECUL | 01 |
| Street Address |
N2950 STATE ROAD 67 |
| City | LAKE GENEVA |
| State | WI |
| Zip Code | 53147-2655 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386631281 | Shweta Pearlstein | Anesthesiology | N2950 State Road 67, Lake Geneva, WI 53147-2655 | 2005-10-05 |
| 1154928547 | Jessica M Grubb | Occupational Therapist | N2950 State Road 67, Lake Geneva, WI 53147-2655 | 2020-10-08 |
| 1063072650 | Madalyn R Douglas | Physical Therapist | N2950 State Road 67, Lake Geneva, WI 53147-2655 | 2019-06-17 |
| 1013421908 | Ashley E. Boro | Occupational Therapist | N2950 State Road 67, Lake Geneva, WI 53147-2655 | 2017-11-30 |
| 1447776950 | Stefanie N Droese | Physical Therapist | N2950 State Road 67, Lake Geneva, WI 53147-2655 | 2017-08-16 |
| 1427573773 | Andrea M. Lysaght | Registered Nurse | N2950 State Road 67, Lake Geneva, WI 53147-2655 | 2017-08-08 |
| 1265956288 | Kyle C. Janicke | Physical Therapist | N2950 State Road 67, Lake Geneva, WI 53147-2655 | 2017-08-01 |
| 1164952891 | Carling M. Johns | Physical Therapist | N2950 State Road 67, Lake Geneva, WI 53147-2655 | 2017-06-15 |
| 1730615030 | Deborah Lynn Young | Registered Nurse | N2950 State Road 67, Lake Geneva, WI 53147-2655 | 2017-05-04 |
| 1386180255 | Shelly M Weis | Physical Therapist | N2950 State Road 67, Lake Geneva, WI 53147-2655 | 2017-01-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356951206 | Emily Tanis | Physical Therapist | 6722 Wi-50, Lake Geneva, WI 53147 | 2020-08-05 |
| 1588295653 | Baylee M Noe | Occupational Therapy Assistant | Sage Meadow of Lake Geneva 6722 Wi-50, Lake Geneva, WI 53147 | 2020-01-28 |
| 1124539556 | Roxanne Weber | Registered Nurse | 146 E. Geneva Square, Lake Geneva, WI 53147 | 2017-10-12 |
| 1386969400 | Emily Kathleen Wilczak | Surgery | N2950 Wi-67, Lake Geneva, WI 53147 | 2010-03-31 |
| 1538294020 | Dale Alan Miller | Pharmacist | 2950 St. Hwy. 67, Lake Geneva, WI 53147 | 2007-02-23 |
| 1689779902 | Balistreri & Associates Physical Therapy | Physical Therapist | 902 Wells Street, Lake Geneva, WI 53147 | 2006-09-13 |
| 1336157981 | Nestor C Alabarca | Internal Medicine | 146 E Geneva Square, Lake Geneva, WI 53147 | 2006-08-03 |
| 1144259375 | Kim M. Cuculi | Occupational Therapist | 800 Geneva Pkwy N Ste 3, Lake Geneva, WI 53147 | 2006-07-01 |
| 1396253571 | Amar Y. Patel | Family Medicine | 146 E Geneva Sq, Lake Geneva, WI 53147 | 2018-01-22 |
| 1679017925 | Christina L. Clancy | Nurse Practitioner | 146 E Geneva Sq, Lake Geneva, WI 53147 | 2016-12-06 |
| Find all providers in zip 53147 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982090676 | Joseph Brantman | Emergency Medicine | Mercy Walworth Medical Center, N2950 Hwy 67, Lake Geneva, WI 53147-2655 | 2015-04-09 |
| 1225415052 | Christopher John Hanson | Emergency Medicine | N2950 State Road 67, Lake Geneva, WI 53147-2655 | 2015-04-30 |
| 1093102378 | Mitchell Sheley | Emergency Medicine | N2950 State Road 67, Lake Geneva, WI 53147-2655 | 2015-04-23 |
| 1619394723 | Christopher M. Tanner | Emergency Medicine | N2950 State Road 67, Lake Geneva, WI 53147-2655 | 2014-03-26 |
| 1699067132 | Geetha Priydarshini Krishnan | Emergency Medicine | N2950 State Road 67, Lake Geneva, WI 53147-2655 | 2011-05-03 |
| 1659699833 | Christy D. Short | Emergency Medicine | N2950 State Road 67, Lake Geneva, WI 53147-2655 | 2010-05-12 |
| 1689817488 | Hamik Biramian | Emergency Medicine | N2950 State Road 67, Lake Geneva, WI 53147-2655 | 2009-04-09 |
| 1518134410 | Elena Caraman Krause | Emergency Medicine | N2950 State Road 67, Lake Geneva, WI 53147-2655 | 2008-05-11 |
| 1780751495 | David R Madenberg | Emergency Medicine | N2950 State Road 67, Lake Geneva, WI 53147-2655 | 2006-11-29 |
| 1003833070 | Nitin Narendir Soorya | Emergency Medicine | N2950 State Road 67, Lake Geneva, WI 53147-2655 | 2006-07-16 |
| Find all providers in LAKE GENEVA | ||||
| City | LAKE GENEVA |
| Zip Code | 53147 |
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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.