DR. KELLY HENRICKSON (NPI# 1033161708) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1033161708 |
Entity Type | Individual |
Full Name | DR. KELLY HENRICKSON |
Credential | MD |
Practice Address |
9000 W Wisconsin Ave Pediatric Infectious Disease Milwaukee WI 53226-4874 |
Practice Telephone | 4143377070 |
Practice Fax Number | 4143377093 |
Mailing Telephone | 4143377070 |
Mailing Fax Number | 4143377093 |
Enumeration Date | 2006-05-17 |
Last Update Date | 2014-02-26 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 2080P0208X |
Pediatrics Specialization: Pediatric Infectious Diseases |
31214 | WI | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
HUMANA | 002000198G | 01 | |
WI | 1033161708 | 05 |
Street Address |
9000 W WISCONSIN AVE PEDIATRIC INFECTIOUS DISEASE |
City | MILWAUKEE |
State | WI |
Zip Code | 53226-4874 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1568466928 | Deborah Costakos | Ophthalmology | 9000 W Wisconsin Ave, Pediatric Ophthalmology, Milwaukee, WI 53226-4874 | 2005-06-13 |
1477154748 | Tara Anne Peloza | Registered Nurse | 9000 W Wisconsin Ave, Milwaukee, WI 53226-4874 | 2020-11-04 |
1518567676 | Carolyn Mcnally Scoptur | Nurse Practitioner | 9000 W Wisconsin Ave, Milwaukee, WI 53226-4874 | 2020-10-28 |
1053910091 | Casey Wolter | Audiologist | 9000 W Wisconsin Ave, Milwaukee, WI 53226-4874 | 2020-10-21 |
1558976001 | Rachel Sawdy | Nurse Practitioner | 9000 W Wisconsin Ave, Milwaukee, WI 53226-4874 | 2020-09-11 |
1205441128 | Kathleen Maloney | Nurse Practitioner | 9000 W Wisconsin Ave, Milwaukee, WI 53226-4874 | 2020-09-09 |
1992319065 | Mariia Steffeny | Nurse Practitioner | 9000 W Wisconsin Ave, Milwaukee, WI 53226-4874 | 2020-09-04 |
1871106575 | Elisabeth Mary Vogt | Clinical Neuropsychologist | 9000 W Wisconsin Ave, Milwaukee, WI 53226-4874 | 2020-08-24 |
1912517277 | Theresa Lauer Kapke | Psychologist | 9000 W Wisconsin Ave, Milwaukee, WI 53226-4874 | 2020-08-03 |
1003425380 | Khira Ahmed-yahia | Nurse Practitioner | 9000 W Wisconsin Ave, Milwaukee, WI 53226-4874 | 2020-07-23 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1912511155 | Alexander Harlan | Pharmacist | 900 N 92nd St, Milwaukee, WI 53226 | 2020-09-04 |
1558985762 | Armghan Haider Ans | Student in an Organized Health Care Education/Training Program | 9200 W. Wisconsin Ave. Froedtert Hospital & Medical Col, Milwaukee, WI 53226 | 2020-06-03 |
1669001103 | Kimberly Tyler | Student in an Organized Health Care Education/Training Program | 8701 W Watertown Plank Road, Medical College of Wisconsin Dept of Internal Medicine, Wauwatosa, WI 53226 | 2020-04-06 |
1972131993 | Francesca Meloy Devine | Student in an Organized Health Care Education/Training Program | Medical Education Office: Children's Corporate Center, 999 N. 92nd St., Suite 730, Milwaukee, WI 53226 | 2020-03-27 |
1285275248 | Sharitta Alford | Technician | 12250 West North Avenue, Apartment 142b, Wauwatosa, WI 53226 | 2019-10-01 |
1619528023 | Linda Marie Sabatinelli | Technician | 12107 W. Woodland Ave, Wauwatosa, WI 53226 | 2019-09-26 |
1598310195 | Matthew Laviolette | Surgery | Medical College of Wisconsin, 8701 Watertown Plank Rd., Surgical Oncology, Milwaukee, WI 53226 | 2019-08-09 |
1962056432 | Lyndsey Marie Bratberg | Physician Assistant | F&mcw Clinical Cancer Center 9200 W. Wisconsin Ave., Milwaukee, WI 53226 | 2019-08-01 |
1659832855 | Benjamin David Seadler | Surgery | Mcw, Department of Surgery, 8701 Watertown Plank Road, Milwaukee, WI 53226 | 2019-03-29 |
1861953267 | Michael Dryden | Student in an Organized Health Care Education/Training Program | 8701 Watertown Plank Rd., Milwaukee, WI 53226 | 2019-03-27 |
Find all providers in zip 53226 |
Taxonomy Code | 2080P0208X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Pediatrics |
Specialization | Pediatric Infectious Diseases |
A pediatrician trained to care for children in the diagnosis, treatment and prevention of infectious diseases. This specialist can apply specific knowledge to affect a better outcome for pediatric infections with complicated courses, underlying diseases that predispose to unusual or severe infections, unclear diagnoses, uncommon diseases and complex or investigational treatments. |
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 Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) was provided by the American Osteopathic Board of Pediatrics. The Certification is no longer offered. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1013117456 | Michelle Lynn Mitchell | Pediatrics | 9000 W Wisconsin Ave, Milwaukee, WI 53226-4874 | 2007-07-24 |
1013112432 | Swati Kumar | Pediatrics | 9000 W Wisconsin Ave, Pediatric Infectious Diseases, Milwaukee, WI 53226-4874 | 2007-06-16 |
1609079326 | Kathleen Therese Ryan Loker | Pediatrics | 9000 W Wisconsin Ave, Milwaukee, WI 53226-4874 | 2007-06-08 |
1962456244 | Michael J Chusid | Pediatrics | 9000 W Wisconsin Ave, Pediatric Infectious Diseases, Milwaukee, WI 53226-4874 | 2006-05-20 |
1053365866 | Peter Havens | Pediatrics | 9000 W Wisconsin Ave, Pediatric Infectious Disease, Milwaukee, WI 53226-4874 | 2006-05-19 |
1720030216 | Rodney E Willoughby | Pediatrics | 9000 W Wisconsin Ave, Pediatric Infectious Diseases, Milwaukee, WI 53226-4874 | 2006-05-16 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1609133875 | Emma Louise Mohr | Pediatrics | American Family Childrens Hospital 1675 Highland Ave, Madison, WI 53792-0001 | 2012-04-12 |
1215391313 | Bryan Vonasek | Pediatrics | Uw Hospitals & Clinics 600 Highland Ave, Madison, WI 53792-0001 | 2016-04-05 |
1356386189 | Sheryl L Henderson | Pediatrics | 2880 University Ave, Madison, WI 53705-3644 | 2006-06-17 |
1447226188 | James H Conway | Pediatrics | 2880 University Ave, Madison, WI 53705 | 2006-02-23 |
1073589727 | Bruce S Klein | Pediatrics | 2880 University Ave, Madison, WI 53705 | 2006-02-23 |
1053387720 | Ellen R Wald | Pediatrics | 600 Highland Ave, Madison, WI 53792-4108 | 2006-02-23 |
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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.