JENNIFER SCIDMORE (NPI# 1033583190) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033583190 |
| Entity Type | Individual |
| Full Name | JENNIFER SCIDMORE |
| Credential | PA-C |
| Practice Address |
3801 Spring St Racine WI 53405 |
| Mailing Address |
3760 N Fremont St Chicago IL 60613-3927 |
| Practice Telephone | 2626874011 |
| Enumeration Date | 2015-11-30 |
| Last Update Date | 2015-11-30 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
3698-23 | WI | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363L00000X | Nurse Practitioner | 3698-23 | WI | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
3801 SPRING ST |
| City | RACINE |
| State | WI |
| Zip Code | 53405 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033115787 | Mark A. Pelton | Pharmacist | 3801 Spring St, Racine, WI 53405-1667 | 2005-06-27 |
| 1528685252 | Tanya Higgins | Nurse Anesthetist, Certified Registered | 3801 Spring St, Racine, WI 53405 | 2020-06-29 |
| 1265774715 | Erin Cecelia Siegel | Internal Medicine | 3801 Spring St, Racine, WI 53405 | 2013-03-22 |
| 1578866448 | Courtney Brooke Hoffman | Nurse Anesthetist, Certified Registered | 3801 Spring St, Racine, WI 53405-1667 | 2010-12-14 |
| 1740595032 | Renate A Villarreal | Physician Assistant | 3801 Spring St, Racine, WI 53405-1667 | 2010-08-11 |
| 1669784112 | Peter David Blochowicz | Nurse Anesthetist, Certified Registered | 3801 Spring St, Racine, WI 53405-1667 | 2010-07-12 |
| 1154651115 | Jeffrey Thomas Vaughan Kroeger | Nurse Anesthetist, Certified Registered | 3801 Spring St, Racine, WI 53405-1667 | 2010-01-13 |
| 1467782748 | Racine Anesthesia Services, LLC | Nurse Anesthetist, Certified Registered | 3801 Spring St, Racine, WI 53405-1667 | 2010-01-08 |
| 1104058528 | Matthew T Czerniak | Physician Assistant | 3801 Spring St, Racine, WI 53405-1667 | 2009-08-18 |
| 1003041070 | Jane Collins | Dietitian, Registered | 3801 Spring St, Racine, WI 53405-1667 | 2009-05-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609407923 | Anita Kathy Nykaza | Dietitian, Registered | 3805 A Suite 311, Racine, WI 53405 | 2020-01-27 |
| 1023666062 | Shawn L Drulia | Physician Assistant | 3805 Spring St #320, Racine, WI 53405 | 2019-09-03 |
| 1235627720 | Oxygen One, Inc. | Durable Medical Equipment & Medical Supplies | 3805a Spring Street, Suite 210, Racine, WI 53405 | 2018-04-30 |
| 1356838650 | Melissa Metzger | Psychologist | 2340 Mohr Ave, Racine, WI 53405 | 2018-04-23 |
| 1689029217 | Melissa Ileen Swainston | Nurse Practitioner | 3803 Spring St., Suite Number 410, Racine, WI 53405 | 2016-05-02 |
| 1215305487 | Denetta Lauraelaine Flowers | Licensed Practical Nurse | 4311 Durand Ave., #104, Mt.pleasant, WI 53405 | 2015-09-04 |
| 1841675204 | Colleen Koderca | Registered Nurse | 3317-meachem Rd, Racine, WI 53405 | 2015-07-28 |
| 1790102986 | Georges Wakim | Specialist/Technologist | 3811 Spring St., Suite 102, Racine, WI 53405 | 2014-03-25 |
| 1982021176 | Matthew F Patzke | Specialist/Technologist | 3811 Spring Street Suite 102, Racine, WI 53405 | 2014-03-25 |
| 1073930269 | Jessica Geisler | Specialist/Technologist | 3811 Spring Street Suite #102, Racine, WI 53405 | 2014-03-25 |
| Find all providers in zip 53405 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093348542 | Christopher Sean Lanctin | Physician Assistant | 557 N 17th St Apt 310, Milwaukee, WI 53233-2128 | 2020-02-12 |
| 1750936068 | Javier Eugenio Font | Physician Assistant | 813 N Clover Ln, Cottage Grove, WI 53527-9433 | 2019-08-04 |
| 1962056432 | Lyndsey Marie Bratberg | Physician Assistant | F&mcw Clinical Cancer Center 9200 W. Wisconsin Ave., Milwaukee, WI 53226 | 2019-08-01 |
| 1588225544 | Hannah Elizabeth Krum | Physician Assistant | S80w17784 Brennan Dr, Muskego, WI 53150-8828 | 2019-06-21 |
| 1255825162 | Katelyn Marie Frankwick | Physician Assistant | 1011 E Spruce St # 6, Abbotsford, WI 54405-9647 | 2018-06-15 |
| 1831644228 | Megan E Nelson | Physician Assistant | 221 E Mills Dr, Lake Mills, WI 53551-1910 | 2016-08-16 |
| 1356717904 | Amy Hermus | Physician Assistant | 451 Butternut Dr, Oregon, WI 53575-1349 | 2015-08-18 |
| 1497168066 | Alexander J Hill | Physician Assistant | 1111 North Road, Mauston, WI 53948-0700 | 2014-06-11 |
| 1487083242 | Andrew John Miller | Physician Assistant | 1521 Lakeview Ave, Wausau, WI 54401-6168 | 2013-11-02 |
| 1386944502 | Bethany Rose Yard | Physician Assistant | 18601 Lincoln Street, Whitehall, WI 54773 | 2010-10-22 |
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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.