JEFFREY ALLEN GREENE (NPI# 1063492221) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063492221 |
| Entity Type | Individual |
| Full Name | JEFFREY ALLEN GREENE |
| Credential | PA |
| Practice Address |
10400 75th St Kenosha WI 53142-7884 |
| Practice Telephone | 2629486770 |
| Mailing Telephone | 2629486770 |
| Enumeration Date | 2006-01-21 |
| Last Update Date | 2012-04-20 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 2332 | WI | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363A00000X | Physician Assistant | 17747 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326241894 | Jeffrey Bryan Greene | Dentist | 10543 E Cortez Dr, Scottsdale, AZ 85259-2938 | 2007-06-11 |
| 1407994205 | Jeffrey I Greene | Dentist | 326 Washington Ave, Kingston, NY 12401-4454 | 2007-02-02 |
| 1447765664 | Jeffrey Robert Greene | Counselor | 8135 Mount Vernon Rd, Saint Louisville, OH 43071-9670 | 2017-12-11 |
| 1669798757 | Jeffrey Greene | Physician Assistant | 275 Collier Rd Nw, Suite 300, Atlanta, GA 30309-1709 | 2010-04-14 |
| 1700060936 | Jeffrey Alan Greene | Dentist | 715 S Main St, 2, Santa Ana, CA 92701-5717 | 2007-12-24 |
| 1376627117 | Jeffrey Greene | Pediatrics | 2609 N Duke St, Suite 1000, Durham, NC 27704-3048 | 2006-10-25 |
| 1033144787 | Jeffrey Greene | Internal Medicine | 104 E 40th St, Suite 603, New York, NY 10016-1801 | 2006-07-11 |
| 1134162142 | Jeffrey Carlin Greene | Emergency Medicine | 397 Wallace Rd, Nashville, TN 37211-4854 | 2006-06-14 |
| 1124070651 | Jeffrey Greene | Family Medicine | 102 Pomona Dr, Greensboro, NC 27407-1616 | 2006-05-16 |
| 1598757122 | Jeffrey Greene | Internal Medicine | 920 Church St N, Suite 255, Concord, NC 28025-2927 | 2005-08-19 |
| Street Address |
10400 75TH ST |
| City | KENOSHA |
| State | WI |
| Zip Code | 53142-7884 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477546737 | Mea-aea Kenosha Sc | Family Medicine | 10400 75th St, Kenosha, WI 53142-7884 | 2005-08-23 |
| 1548877707 | Megan Labine | Dietitian, Registered | 10400 75th St, Kenosha, WI 53142-7884 | 2020-09-30 |
| 1730796574 | Saralyn Paredes | Nurse Practitioner | 10400 75th St, Kenosha, WI 53142-7884 | 2020-09-25 |
| 1518586965 | Ariel Adelsen | Registered Nurse | 10400 75th St, Kenosha, WI 53142-7884 | 2020-04-15 |
| 1134757073 | Amber Jirschele | Nurse Practitioner | 10400 75th St, Kenosha, WI 53142-8323 | 2020-03-27 |
| 1912539974 | Kristina A Roscizewski | Nurse Practitioner | 10400 75th St, Kenosha, WI 53142-7884 | 2020-02-07 |
| 1386274413 | Ethan Nathaniel Mcfaddin | Pharmacist | 10400 75th St, Kenosha, WI 53142-7884 | 2020-01-16 |
| 1972133031 | Patricia Grzyb | Physician Assistant | 10400 75th St, Kenosha, WI 53142-7884 | 2020-01-16 |
| 1144873654 | Lauren Cornejo | Occupational Therapist | 10400 75th St, Kenosha, WI 53142-8323 | 2019-07-23 |
| 1245710771 | Brenda Joyce Woodhull | Registered Nurse | 10400 75th St, Kenosha, WI 53142-7884 | 2018-08-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588297816 | Caring Hearts Home Health Care | In Home Supportive Care | 6021-57th Ave, Suite C103, Kenosha, WI 53142 | 2020-02-14 |
| 1144785395 | Michael L Wrzesinski | Counselor | 4109 67th Street, Kenosha, WI 53142 | 2019-02-01 |
| 1720538499 | David Smith | Counselor | 10900 67th Street, Kenosha, WI 53142 | 2016-10-06 |
| 1326404641 | Smile Doctors Ltd | Dentist | 7003 39th Ave, Kenosha, WI 53142 | 2016-01-04 |
| 1225409485 | Antonia Marie Decker | Physician Assistant | 10400 75th St. Ste 204, Kenosha, WI 53142 | 2015-10-14 |
| 1780060582 | Joshua Haas | Pharmacist | 7701 Green Bay Road, Kenosha, IL 53142 | 2015-08-04 |
| 1811379225 | Dana Mary Stout | Registered Nurse | 7401 104th Avenue, Suite 110, Comprehensive Orthopaedics, S.c., Kenosha, WI 53142 | 2015-06-22 |
| 1669815569 | Joshua Knute Elson | Radiology | 6811 118th Ave, Kenosha, WI 53142 | 2013-04-10 |
| 1356610166 | Michael J Gallo | Pharmacist | 7535 North Greenbay Rd, Kenosha, WI 53142 | 2011-12-22 |
| 1720357999 | Orest Carnevale | Registered Nurse | 7316 155th Ct, Kenosha, WI 53142 | 2011-12-18 |
| Find all providers in zip 53142 | ||||
| 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 |
|---|---|---|---|---|
| 1043843592 | Brian Owings | Physician Assistant | 3400 Market Ln # 300, Kenosha, WI 53144-3430 | 2020-02-12 |
| 1225409485 | Antonia Marie Decker | Physician Assistant | 10400 75th St. Ste 204, Kenosha, WI 53142 | 2015-10-14 |
| 1215311881 | Sarah Ann Moony | Physician Assistant | 8500 75th St Ste 102, Kenosha, WI 53142-8213 | 2015-07-14 |
| 1194097311 | Emily Ann Lee | Physician Assistant | 10400 75th St Ste 215, Kenosha, WI 53142-7884 | 2012-02-03 |
| 1629364815 | Alyssa M Ricchio | Physician Assistant | 10400 75th St Ste 700, Kenosha, WI 53142-7884 | 2011-06-26 |
| 1649506874 | Briana Elizabeth Aiken | Physician Assistant | 2801 14th Pl, Kenosha, WI 53140-4300 | 2009-10-22 |
| 1144317736 | Sarah N Stachon | Physician Assistant | 8959 34th Ave, Kenosha, WI 53142-5412 | 2006-10-06 |
| 1457468654 | Yasmine S Sido | Physician Assistant | 7550 22nd Ave, Kenosha, WI 53143 | 2006-08-24 |
| 1154377091 | Keven R Mottinger | Physician Assistant | 3400 Market Ln, Kenosha, WI 53144-3430 | 2006-05-25 |
| 1164056727 | Michael James Church | Physician Assistant | 6308 8th Ave, Kenosha, WI 53143-5031 | 2020-02-23 |
| Find all providers in KENOSHA | ||||
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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.