FROEDTERT & THE MEDICAL COLLEGE OF WISCONSIN COMMUNITY PHYSICIANS (NPI# 1053759571) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053759571 |
| Entity Type | Organization |
| Organization Name | FROEDTERT & THE MEDICAL COLLEGE OF WISCONSIN COMMUNITY PHYSICIANS |
| Other Organization Name | FROEDTERT PHYSICIAN PARTNERS, INC. |
| Practice Address |
3200 Pleasant Valley Rd West Bend WI 53095-9274 |
| Practice Telephone | 2623343451 |
| Practice Fax Number | 2628362436 |
| Mailing Telephone | 2623343451 |
| Mailing Fax Number | 2628362436 |
| Enumeration Date | 2013-06-06 |
| Last Update Date | 2014-08-27 |
| Authorized Official Name | MRS. CATHERINE MODE EASTHAM (GENERAL COUNSEL) |
| Authorized Official Telephone | 4148052994 |
| Authorized Official Credential | ESQ. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers |
| Other Name | Type Code |
|---|---|
| Froedtert Physician Partners, Inc. | Former Legal Business Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780142992 | Froedtert & The Medical College of Wisconsin Community Physicians | Non-Pharmacy Dispensing Site | 11040 N Range Line Rd, Mequon, WI 53092-4930 | 2019-03-06 |
| 1992284087 | Froedtert & The Medical College of Wisconsin Community Physicians | Non-Pharmacy Dispensing Site | 4859 South 60th Street, Greenfield, WI 53220 | 2018-08-09 |
| 1801373378 | Froedtert & The Medical College of Wisconsin Community Physicians | Non-Pharmacy Dispensing Site | 1721 W Canal St, Milwaukee, WI 53233 | 2018-07-26 |
| 1831482298 | Froedtert & The Medical College of Wisconsin Community Physicians | Durable Medical Equipment & Medical Supplies | W168n11237 Western Avenue, Germantown, WI 53022-3239 | 2011-05-18 |
| 1609214121 | Froedtert & The Medical College of Wisconsin Community Physicians | Durable Medical Equipment & Medical Supplies | 110 Lone Oak Ln, Hartford, WI 53027-2600 | 2013-06-06 |
| 1780021493 | Froedtert & The Medical College of Wisconsin Community Physicians | Durable Medical Equipment & Medical Supplies | 1190 E Paradise Dr, West Bend, WI 53095-5444 | 2013-06-04 |
| 1134413677 | Froedtert & The Medical College of Wisconsin Community Physicians | Durable Medical Equipment & Medical Supplies | W178n9201 Water Tower Pl, Menomonee Falls, WI 53051-8029 | 2011-06-01 |
| Street Address |
3200 PLEASANT VALLEY RD |
| City | WEST BEND |
| State | WI |
| Zip Code | 53095-9274 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568453223 | Ajit B Divgi | Internal Medicine | 3200 Pleasant Valley Rd, Kraemer Cancer Care Center, West Bend, WI 53095-9274 | 2005-11-02 |
| 1992328553 | Elizabeth Dille | Family Medicine | 3200 Pleasant Valley Rd, West Bend, WI 53095-9274 | 2020-05-18 |
| 1407378086 | Amalia A Brouillard | Nurse Practitioner | 3200 Pleasant Valley Rd, West Bend, WI 53095-9274 | 2017-07-14 |
| 1194259291 | Amy Mannes | Occupational Therapist | 3200 Pleasant Valley Rd, West Bend, WI 53095-9274 | 2017-04-14 |
| 1033667688 | Jennifer Esser | Physician Assistant | 3200 Pleasant Valley Rd, West Bend, WI 53095-9274 | 2016-09-12 |
| 1831558113 | Andrea M Pipito | Nurse Practitioner | 3200 Pleasant Valley Rd, West Bend, WI 53095-9274 | 2016-02-16 |
| 1659743318 | Meghan Lynn Christian | Nurse Practitioner | 3200 Pleasant Valley Rd, Pulmonary Diseases, West Bend, WI 53095-9274 | 2015-10-21 |
| 1043699176 | Froedtert & The Medical College of Wisconsin Community Physicians Inc | Clinical Medical Laboratory | 3200 Pleasant Valley Rd, West Bend, WI 53095-9274 | 2015-05-21 |
| 1376935395 | Jessica Anne Held | Nurse Practitioner | 3200 Pleasant Valley Rd, West Bend, WI 53095-9274 | 2015-02-27 |
| 1700229846 | Tracy Drake | Family Medicine | 3200 Pleasant Valley Rd, West Bend, WI 53095-9274 | 2013-04-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942820428 | David Fountain | Contractor | 726 Creedwood Lane, West Bend, WI 53095 | 2020-04-24 |
| 1922664358 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 1745 South Main St, West Bend, WI 53095 | 2019-05-10 |
| 1912423773 | Michelle R Prentice | Family Medicine | West Bend Health Center, 1700 W. Paradise Drive, West Bend, WI 53095 | 2017-08-14 |
| 1386165918 | Quad/med, LLC | Clinic/Center | 432 E. Washington St. #1115, West Bend, WI 53095 | 2017-07-05 |
| 1508230632 | Jesen Daniel | Counselor | 111 East Washington St, Affiliated Clinical Services, West Bend, WI 53095 | 2015-12-01 |
| 1477965259 | Jenna Crofts | Specialist/Technologist | 1190 East Paradise Drive, West Bend, WI 53095 | 2014-05-28 |
| 1023436342 | Visionworks | Optometrist | 1437 S. Main St., West Bend, WI 53095 | 2014-04-03 |
| 1295157295 | Stephanie Rabe | Registered Nurse | 910 E. Paradise Drive, West Bend, WI 53095 | 2014-01-09 |
| 1477898815 | Ralph Norman Olsen | Pediatrics | 6267 Riesch Road, West Bend, WI 53095 | 2012-12-11 |
| 1932458536 | Joshua Aaron Barta | Dentist | 2090 Continental Drive, West Bend, WI 53095 | 2012-08-29 |
| Find all providers in zip 53095 | ||||
| Taxonomy Code | 332B00000X |
| Grouping | Suppliers |
| Classification | Durable Medical Equipment & Medical Supplies |
| A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient’s use in the home and that are usable for an extended period of time. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598085367 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 1720 W Washington St, West Bend, WI 53095-2311 | 2010-06-03 |
| 1598789257 | Wheelchair Guy, LLC | Durable Medical Equipment & Medical Supplies | 3800 S River Rd, Unit A, West Bend, WI 53095-7845 | 2006-07-27 |
| 1821018375 | Apl Medical, Inc. | Durable Medical Equipment & Medical Supplies | 6340 State Road 144 S, West Bend, WI 53095-9118 | 2006-07-20 |
| 1629095799 | Wal-mart Stores East Lp | Durable Medical Equipment & Medical Supplies | 1515 W Paradise Dr, West Bend, WI 53095-9794 | 2006-07-16 |
| 1407419328 | Pain Centers of Wisconsin - West Bend, LLC | Durable Medical Equipment & Medical Supplies | 1000 Gateway Ct, West Bend, WI 53095-8541 | 2019-04-16 |
| 1396280160 | Meijer Stores Limited Partnership | Durable Medical Equipment & Medical Supplies | 2180 S Main St, West Bend, WI 53095-5754 | 2017-01-03 |
| 1093180184 | Genoa Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 333 E Washington St Ste 2100, West Bend, WI 53095-2503 | 2015-12-01 |
| 1720472558 | Advanced Pain Management Sc | Durable Medical Equipment & Medical Supplies | 1000 Gateway Ct, Suite 200, West Bend, WI 53095-8541 | 2015-03-18 |
| 1407269335 | Aurora Advanced Healthcare Inc | Durable Medical Equipment & Medical Supplies | 1100 Gateway Ct, West Bend, WI 53095-8539 | 2014-06-09 |
| 1225476740 | Froedtert & The Medical College of Wisconsin Community Physicians Inc | Durable Medical Equipment & Medical Supplies | 1700 W Paradise Dr, West Bend, WI 53095-9795 | 2013-06-06 |
| Find all providers in WEST BEND | ||||
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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.