ANNETTE RENNA MCKNIGHT (NPI# 1053833707) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053833707 |
| Entity Type | Individual |
| Full Name | ANNETTE RENNA MCKNIGHT |
| Other Name | ANNETTE RENNA WILSON |
| Practice Address |
4929 W Fond Du Lac Ave Milwaukee WI 53216-2324 |
| Practice Telephone | (414) 871-6122 |
| Practice Fax Number | 4148712552 |
| Mailing Telephone | 4148716122 |
| Mailing Fax Number | 4148712552 |
| Enumeration Date | 2017-07-14 |
| Last Update Date | 2017-07-14 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 175T00000X | Peer Specialist | Other Service Providers |
| Street Address |
4929 W FOND DU LAC AVE |
| City | MILWAUKEE |
| State | WI |
| Zip Code | 53216-2324 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952465783 | Susan Beverly Collyard | Counselor | 4929 W Fond Du Lac Ave, Milwaukee, WI 53216-2324 | 2006-12-19 |
| 1881236057 | Nyairah Shana Abdullah | Case Manager/Care Coordinator | 4929 W Fond Du Lac Ave, Milwaukee, WI 53216-2324 | 2019-10-09 |
| 1508408626 | Shelby Wilson | Counselor | 4929 W Fond Du Lac Ave, Milwaukee, WI 53216-2324 | 2019-10-09 |
| 1639711856 | Ayasha Nichelle Marshall | Case Manager/Care Coordinator | 4929 W Fond Du Lac Ave, Milwaukee, WI 53216-2324 | 2019-10-09 |
| 1669932398 | Latasha N Woods | Case Manager/Care Coordinator | 4929 W Fond Du Lac Ave, Milwaukee, WI 53216-2324 | 2019-03-20 |
| 1700369212 | Esma Yvonne Mitchell | Case Manager/Care Coordinator | 4929 W Fond Du Lac Ave, Milwaukee, WI 53216-2324 | 2018-09-11 |
| 1053894584 | Nicole T. Gail | Case Manager/Care Coordinator | 4929 W Fond Du Lac Ave, Milwaukee, WI 53216-2324 | 2018-09-11 |
| 1124501655 | Dorothy S. Stevenson | Case Manager/Care Coordinator | 4929 W Fond Du Lac Ave, Milwaukee, WI 53216-2324 | 2018-09-11 |
| 1417430158 | Kristina Marie Schramkowski | Case Manager/Care Coordinator | 4929 W Fond Du Lac Ave, Milwaukee, WI 53216-2324 | 2018-09-10 |
| 1043722861 | Joan Patricia Roseman | Case Manager/Care Coordinator | 4929 W Fond Du Lac Ave, Milwaukee, WI 53216-2324 | 2017-11-02 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750906137 | Lilshana Woods | Technician | 3946 N 52nd St, Milwaukee, WI 53216 | 2020-06-11 |
| 1063981710 | Jon Maurice Smoots | Prevention Professional | 7710 W. Casper Street, Milwaukee, WI 53216 | 2018-11-23 |
| 1467948844 | Alexcis Coleman | Counselor | 6815 W Capitol Dr Ste 217, Milwaukee, WI 53216 | 2018-07-09 |
| 1457841066 | Rebeka Fried | Occupational Therapist | 3134 N 53rd St, Milwaukee, WI 53216 | 2018-05-18 |
| 1952831497 | Nina Marie Evans | Home Health Aide | 6815 W. Capitol Drive Suite 117, Milwaukee, WI 53216 | 2017-06-18 |
| 1578009080 | Annette L Veasey | Counselor | 4222 W Capitol Dr Ste 308, Milwaukee, WI 53216 | 2017-01-09 |
| 1295277143 | Gentle Hands Home Healthcare | Home Health | 6815 N. 68th Street, Milwaukee, WI 53216 | 2016-11-09 |
| 1639622780 | Luisa Julia Morales | Counselor | 5228 Fond Du Lac Ave, Milwaukee, WI 53216 | 2016-07-25 |
| 1568811776 | Eye-care Home Health Care | In Home Supportive Care | 6221 W Keefe Pkwy, Milwaukee, WI 53216 | 2016-06-08 |
| 1013382167 | Helens Supportive Services | Home Health | 6222 W Capitol Drive Sutie 200c, Milwaukee, WI 53216 | 2015-12-01 |
| Find all providers in zip 53216 | ||||
| Taxonomy Code | 175T00000X |
| Grouping | Other Service Providers |
| Classification | Peer Specialist |
| Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority. |
| Notes: Source: National Uniform Claim Committee [7/1/2014: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477023729 | Subdoc | Peer Specialist | 7275 N Port Washington Rd Apt 314, Milwaukee, WI 53217-3337 | 2018-11-29 |
| 1063055192 | Jerome Allen Larson | Peer Specialist | 3090 N 53rd St, Milwaukee, WI 53210-1617 | 2019-10-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265923148 | William Thomas Humphrey | Peer Specialist | 433 W Maple St, Viroqua, WI 54665-1930 | 2018-05-25 |
| 1104338920 | Casey Bobinger | Peer Specialist | 412 E North St Ste A, Waukesha, WI 53188-3720 | 2017-11-02 |
| 1750739033 | Tracey Zwieg | Peer Specialist | 1700 Elder St, Waukesha, WI 53188-3234 | 2016-05-27 |
| 1376990069 | Greta Petersen | Peer Specialist | 412 E North St, Waukesha, WI 53188-3720 | 2016-05-23 |
| 1902452949 | Tara H Wilhelmi | Peer Specialist | 6417 Odana Rd., Suite 5, Madison, WI 53719 | 2019-08-15 |
| 1295221174 | Peter Joseph Rossmeissl | Peer Specialist | 1320 Mendota St Ste 106, Madison, WI 53714-1096 | 2018-07-03 |
| 1215386347 | Susan Schmidt | Peer Specialist | 412 E North St, Suite A, Waukesha, WI 53188-3720 | 2016-06-09 |
| 1902255987 | Steven Splittgerber | Peer Specialist | 412 E North St, Suite A, Waukesha, WI 53188-3720 | 2016-06-09 |
| 1417306879 | Kathleen Mack | Peer Specialist | 412 E North St, Suite A, Waukesha, WI 53188-3720 | 2016-06-07 |
| 1366899056 | Marty Lemon | Peer Specialist | 412 E North St, Waukesha, WI 53188-3720 | 2016-05-23 |
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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.