KILEY DEHAVEN (NPI# 1063071157) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063071157 |
| Entity Type | Individual |
| Full Name | KILEY DEHAVEN |
| Credential | PA-C |
| Practice Address |
1821 S Stoughton Rd Madison WI 53716-2257 |
| Mailing Address |
1808 W Beltline Hwy Madison WI 53713-2334 |
| Practice Telephone | 6082606000 |
| Mailing Telephone | 6082501497 |
| Mailing Fax Number | 6082501384 |
| Enumeration Date | 2019-06-12 |
| Last Update Date | 2020-11-06 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 1063071157 | 05 |
| Street Address |
1821 S STOUGHTON RD |
| City | MADISON |
| State | WI |
| Zip Code | 53716-2257 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679569024 | Amanda Jean Johnson | Physician Assistant | 1821 S Stoughton Rd, Dean Medical Center, Madison, WI 53716-2257 | 2005-09-21 |
| 1316544638 | Whitney M Wisecup | Nurse Practitioner | 1821 S Stoughton Rd, Madison, WI 53716-2257 | 2020-10-09 |
| 1013475656 | Shannon A Gedman | Nurse Practitioner | 1821 S Stoughton Rd, Madison, WI 53716-2257 | 2019-03-02 |
| 1295221059 | Emily Lyght | Physician Assistant | 1821 S Stoughton Rd, Madison, WI 53716 | 2018-07-05 |
| 1497245674 | Julie J Empey | Dietitian, Registered | 1821 S Stoughton Rd, Madison, WI 53716-2257 | 2018-05-14 |
| 1184131864 | Heather E Solfelt | Dietitian, Registered | 1821 S Stoughton Rd, Madison, WI 53716-2257 | 2018-01-04 |
| 1508385519 | Jennifer D Foy | Nurse Practitioner | 1821 S Stoughton Rd, Madison, WI 53716 | 2017-09-12 |
| 1336668276 | Teri L White | Nurse Practitioner | 1821 S Stoughton Rd, Madison, WI 53716-2257 | 2017-09-12 |
| 1457877284 | Jennifer L Wachholz | Physician Assistant | 1821 S Stoughton Rd, Madison, WI 53716-2257 | 2017-08-14 |
| 1386174571 | Robyn Lyn Brownell | Family Medicine | 1821 S Stoughton Rd, Madison, WI 53716-2257 | 2017-06-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730738873 | Richard Onyait | Technician | 1103 Birch Haven Cir, Monona, WI 53716 | 2019-09-11 |
| 1962950428 | Paige Corliss | Pharmacist | 1821 S. Stoughton Road, Madison, WI 53716 | 2016-09-13 |
| 1760840946 | Stacey Palermo | Marriage & Family Therapist | 303 Frost Woods Rd, Monona, WI 53716 | 2016-02-03 |
| 1326414442 | Diane Marie Kelley | Nurse Practitioner | 300 Femrite Drive, Monona, WI 53716 | 2015-08-12 |
| 1942692520 | Kelsey Lynn Markham | Counselor | 5900 Monona Drive, Suite 100, Monona, WI 53716 | 2015-02-19 |
| 1225452733 | Nicole Moscinski | Marriage & Family Therapist | 6117 Monona Dr Ste 1b, Monona, WI 53716 | 2014-02-05 |
| 1013345644 | Emma Amanda Rose | Physician Assistant | 521 Bowman Ave., Madison, WI 53716 | 2013-10-16 |
| 1407154271 | Jennifer Orshak | Registered Nurse | 5410 Forge Drive, Madison, WI 53716 | 2011-03-03 |
| 1982906525 | Jennifer Chun | Dentist | 100 River Pl Ste 110, Monona, WI 53716 | 2010-12-02 |
| 1609041987 | Jennifer A Britain | Physical Therapist | 1821 South Stoughton Rd, Madison, WI 53716 | 2008-04-28 |
| Find all providers in zip 53716 | ||||
| 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 |
|---|---|---|---|---|
| 1710594403 | Mary Josephine Elliott | Physician Assistant | 50 Beechwood Dr, Madison, CT 06443-1847 | 2020-09-26 |
| 1194354928 | Shqipe Ademi | Physician Assistant | 5417 Hazelcrest Dr, Madison, WI 53704-8910 | 2020-04-03 |
| 1902432685 | Therese Rowe | Physician Assistant | 1 Point Pl Ste 200, Madison, WI 53719-2836 | 2020-03-13 |
| 1437784139 | Mark Mckinney | Physician Assistant | 750 Highland Ave # Hslc1270, Madison, WI 53705-2221 | 2020-03-03 |
| 1619511706 | Nicole Frakes | Physician Assistant | 750 Highland Ave, Madison, WI 53705-2221 | 2019-10-31 |
| 1508428558 | Martha Busse | Physician Assistant | 1650 Monroe St Apt D, Madison, WI 53711-2045 | 2019-06-30 |
| 1669942249 | Patrick Soltvedt Bohn | Physician Assistant | 1034 Waban Hill, Madison, WI 53711 | 2018-11-27 |
| 1487124020 | Kaitlyn Jolena Mcmackin | Physician Assistant | 120 Fountains Blvd Ste 1000, Madison, MS 39110-6343 | 2018-11-27 |
| 1013493907 | Paulina A Hall | Physician Assistant | 700 S Park St Suite A, Madison, WI 53715-5228 | 2018-07-13 |
| 1700370020 | Mark Diaz IIi | Physician Assistant | 77 S Oakbridge Ct Apt 105, Madison, WI 53717-2030 | 2018-06-20 |
| Find all providers in MADISON | ||||
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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.