KETTLE MORAINE YMCA, INC. YOUNG MEN'S CHRISTIAN ASSOCIATION (NPI# 1073062949) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073062949 |
| Entity Type | Organization |
| Organization Name | KETTLE MORAINE YMCA, INC. YOUNG MEN'S CHRISTIAN ASSOCIATION |
| Practice Address |
1111 W Washington St West Bend WI 53095-2433 |
| Practice Telephone | 2623343405 |
| Practice Fax Number | 2623345414 |
| Mailing Telephone | 2623343405 |
| Mailing Fax Number | 2623345414 |
| Enumeration Date | 2016-10-03 |
| Last Update Date | 2016-10-03 |
| Authorized Official Name | MR. ROB JOHNSON (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 2622471006 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174H00000X | Health Educator | Other Service Providers |
| Street Address |
1111 W WASHINGTON ST |
| City | WEST BEND |
| State | WI |
| Zip Code | 53095-2433 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225519234 | Mary Beth Emmer | Health Educator | 1111 W Washington St, West Bend, WI 53095 | 2018-08-27 |
| 1235610239 | Heather Cromb | Health Educator | 1111 W Washington St, West Bend, WI 53095-2433 | 2018-08-27 |
| 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 | 174H00000X |
| Grouping | Other Service Providers |
| Classification | Health Educator |
| Health educators work in a variety of settings providing education to individuals or groups of individuals on healthy behaviors, wellness, and health-related topics with the goal of preventing diseases and health problems. Health educators generally require a bachelor’s degree and may receive additional training, such as through mentoring, internships, or volunteer work. |
| Notes: Source: National Uniform Claim Committee, 2009 [7/1/2009: definition added] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518449040 | Gina Trampe | Health Educator | 705 Village Green Way Unit 201, West Bend, WI 53090-2528 | 2018-08-31 |
| 1225519234 | Mary Beth Emmer | Health Educator | 1111 W Washington St, West Bend, WI 53095 | 2018-08-27 |
| 1235610239 | Heather Cromb | Health Educator | 1111 W Washington St, West Bend, WI 53095-2433 | 2018-08-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922609692 | Tanya Rosenthal | Health Educator | W4991 Wege Rd, Appleton, WI 54913-8354 | 2020-11-08 |
| 1205461068 | Judith Gail Hahn | Health Educator | 2336 W Green Tree Road, Glendale, WI 53209-2704 | 2020-03-11 |
| 1467003665 | Erika Chavez | Health Educator | 1313 E Randolph Ct Apt D, Milwaukee, WI 53212-1857 | 2019-09-28 |
| 1285280156 | Tonia M Davis | Health Educator | 8139 W Custer Ave, Milwaukee, WI 53218-3533 | 2019-08-15 |
| 1154983500 | Amy Lynn Lewis | Health Educator | 5299 Easy St, Waunakee, WI 53597-9767 | 2019-07-06 |
| 1023670049 | Michelle Uetz | Health Educator | 370 County Road U, River Falls, WI 54022-8268 | 2019-06-29 |
| 1568921278 | Sword Health Inc | Health Educator | 1020 North Broadway, Milwaukee, WI 53202 | 2019-03-13 |
| 1871086645 | Megan Kilsdonk | Health Educator | 1604 N Meade St, Appleton, WI 54911 | 2018-06-07 |
| 1679065593 | Young Men's Christian Association of Metropolitan Milwaukee, Inc. | Health Educator | 161 West Wisconsin Avenue, Suite 4000, Milwaukee, WI 53203-2601 | 2018-06-06 |
| 1811406648 | Door County Young Men's Christian Association Inc | Health Educator | 1900 Michigan Street, Sturgeon Bay, WI 54235 | 2017-09-25 |
| Find all providers with the same taxonomy | ||||
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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.