SUSAN KAY BOLAND (NPI# 1023136512) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023136512 |
| Entity Type | Individual |
| Full Name | SUSAN KAY BOLAND |
| Other Name | SUSAN KAY PENDELL-ROGERS |
| Credential | P.A. |
| Practice Address |
300 North Washington Street Darien Medical Clinic Darien WI 53114-1534 |
| Mailing Address |
1905 E. Huebbe Parkway Beloit Health System Inc Beloit WI 53511-1842 |
| Practice Telephone | 2628821151 |
| Practice Fax Number | 2622961195 |
| Mailing Telephone | 6083642200 |
| Mailing Fax Number | 6083637395 |
| Enumeration Date | 2007-03-26 |
| Last Update Date | 2011-03-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 2122-23 | WI | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363A00000X | Physician Assistant | 085001543 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 1023136512 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396075099 | Susan T Boland | Physical Therapist | 201 N Jackson St Lowr Floor, Media, PA 19063-2926 | 2010-01-04 |
| 1730245457 | Susan Carmen Boland | Massage Therapist | 2101 Tamiami Trl, Port Charlotte, FL 33948-2186 | 2006-12-28 |
| 1588653091 | Susan Boland | Nurse Practitioner | 1680 Hospital South Dr, Austell, GA 30106-8110 | 2005-10-18 |
| Street Address |
300 NORTH WASHINGTON STREET DARIEN MEDICAL CLINIC |
| City | DARIEN |
| State | WI |
| Zip Code | 53114-1534 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366497414 | Village of Darien | Ambulance | 311 W Madison St, Darien, WI 53114 | 2006-05-24 |
| 1285032664 | Ulma Anclam | Physical Therapy Assistant | 13113 E Creek Rd, Darien, WI 53114-1127 | 2014-12-16 |
| 1851696371 | Traci J Lebow | Registered Nurse | W9656 Us Highway 14, Darien, WI 53114-1232 | 2011-01-13 |
| 1942690151 | Chad Triscuit | Naturopath | 124 N Walworth St, Darien, WI 53114-1516 | 2015-01-26 |
| 1447859806 | Margaret Grace Mcgraw | Family Medicine | 124 N Walworth St, Darien, WI 53114-1516 | 2020-10-18 |
| 1265575195 | Beloit Health System, Inc | Family Medicine | 300 N Walworth St, Darien, WI 53114-1534 | 2007-02-14 |
| 1609316298 | Meghan Carol Smith | Specialist/Technologist | 122 Donna Ave, Darien, WI 53114-1565 | 2017-03-01 |
| 1891129391 | Angela A Fox | Licensed Practical Nurse | 348 Parkview Dr, Darien, WI 53114-1576 | 2013-09-03 |
| 1679965974 | Breanna Jenkins | Licensed Practical Nurse | 551 Oak Ridge Dr, Darien, WI 53114-1577 | 2015-02-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629679428 | Jessica Scharf | Psychologist | 8502 Bailey Rd # 63, Darien, IL 60561-5333 | 2020-11-06 |
| 1417556317 | New England Advanced Spine & Pain Center LLC | Anesthesiology | 137 Hollow Tree Ridge Rd Apt 223, Darien, CT 06820-4056 | 2020-10-21 |
| 1023620184 | Christine Adams Osborn | Counselor | 32 Delafield Island Rd, Darien, CT 06820-6010 | 2020-08-20 |
| 1285245902 | Meiram Khalil | Pharmacist | 7516 Cass Ave Ste 1, Darien, IL 60561-4457 | 2020-08-14 |
| 1578174488 | Michael G Giambrone | Physical Therapist | 19 Old Kings Hwy S, Darien, CT 06820-4533 | 2020-08-13 |
| 1346859709 | Andre Burey Md Pllc | Psychiatry & Neurology | 1051 Post Rd Ste 1, Darien, CT 06820-5436 | 2020-07-30 |
| 1609484468 | Shane Saji Jacob | Physician Assistant | 18w194 Claremont Dr, Darien, IL 60561-3640 | 2020-07-17 |
| 1518585967 | Afua Opoku Aning | Technician, Health Information | 1021 Meadowlark Ln, Darien, IL 60561-5416 | 2020-07-13 |
| 1801413190 | Rachel Lynn Boehmert | Behavioral Analyst | 8149 South Cass Avenue, Darien, IL 60561 | 2020-07-02 |
| 1386261212 | Diana Louise Botticelli | Specialist | 5 Jackson Pl, Darien, CT 06820-2725 | 2020-06-26 |
| Find all providers in DARIEN | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609484468 | Shane Saji Jacob | Physician Assistant | 18w194 Claremont Dr, Darien, IL 60561-3640 | 2020-07-17 |
| 1245855543 | Lina Starovoitova | Physician Assistant | 22 Wakemore St, Darien, CT 06820-2411 | 2020-06-11 |
| 1033571096 | Jeanette Marinier | Physician Assistant | 7421 Cass Ave, Darien, IL 60561 | 2016-03-28 |
| 1780053983 | Keri Plica | Physician Assistant | 722 69th St, Darien, IL 60561-3825 | 2015-09-17 |
| 1891886156 | Christina Martineau | Physician Assistant | 23 Old Stone Rd, Darien, CT 06820-4419 | 2006-09-28 |
| 1922518513 | Erin Elizabeth Browne | Physician Assistant | 8190 Cass Ave, Darien, IL 60561-5013 | 2017-10-09 |
| 1265833578 | Wei Wei | Physician Assistant | 8190 S Cass Ave, Darien, IL 60561-5013 | 2014-09-07 |
| 1174946750 | Melissa Pulcini-buttine | Physician Assistant | 106 Noroton Ave, Darien, CT 06820-5237 | 2014-02-02 |
| 1922287614 | Karen A Smith | Physician Assistant | 8110 S Cass Ave, Darien, IL 60561-5013 | 2007-10-30 |
| 1396946158 | Robert James Lucas | Physician Assistant | 17 Old Kings Highway South, A & M Surgery, Darien, CT 06820 | 2007-05-30 |
| Find all providers in DARIEN | ||||
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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.