TIMOTHY A. SANBORN (NPI# 1073600987) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1073600987 |
Entity Type | Individual |
Full Name | TIMOTHY A. SANBORN |
Credential | M.D. |
Practice Address |
6308 8th Ave Kenosha WI 53143 |
Mailing Address |
7901 S 6th St Oak Creek WI 53154-2010 |
Practice Telephone | 2626533650 |
Practice Fax Number | 2626563672 |
Mailing Telephone | 4143468000 |
Mailing Fax Number | 4143468010 |
Enumeration Date | 2006-10-10 |
Last Update Date | 2018-07-25 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
69326 | WI | Allopathic & Osteopathic Physicians |
N | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
036102493 | IL | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
WI | 1073600987 | 05 |
Address | Telephone Number | Fax Number |
---|---|---|
2050 Pfingsten Rd, Suite 360, Glenview, IL 600261324 | 8476571819 | 8476571898 |
7901 S 6th St, Oak Creek, WI 531542010 | 4143468000 | 4143468010 |
9555 76th St, Pleasant Prairie, WI 531581984 | 2626563650 | 2626563672 |
Street Address |
6308 8TH AVE |
City | KENOSHA |
State | WI |
Zip Code | 53143 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1366440851 | Janet S Barney | Nurse Practitioner | 6308 8th Ave, Suite 2000, Kenosha, WI 53143-5031 | 2005-07-08 |
1669094165 | Simona Slavinskiene | Nurse Practitioner | 6308 8th Ave, Kenosha, WI 53143-5031 | 2020-05-07 |
1366063133 | Lisa Neyens | Pharmacist | 6308 8th Ave, Kenosha, WI 53143-5031 | 2020-05-02 |
1164056727 | Michael James Church | Physician Assistant | 6308 8th Ave, Kenosha, WI 53143-5031 | 2020-02-23 |
1215593009 | Ihc-wound Care Services LLC | Emergency Medicine | 6308 8th Ave, Kenosha, WI 53143-5031 | 2019-05-16 |
1609358357 | Samantha M Rhodes | Physical Therapist | 6308 8th Ave, Kenosha, WI 53143-5031 | 2018-08-29 |
1063953784 | Megan Roethle | Registered Nurse | 6308 8th Ave, Kenosha, WI 53143-5031 | 2017-03-14 |
1043678683 | Sarah Rens | Physician Assistant | 6308 8th Ave, Kenosha, WI 53143-5031 | 2016-02-09 |
1922472422 | Catherine A Hernandez | Physician Assistant | 6308 8th Ave, Kenosha, WI 53143-5031 | 2015-11-20 |
1750779856 | Elliot M Simon | Physician Assistant | 6308 8th Ave, Suite 1020, Kenosha, WI 53143-5031 | 2014-12-26 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1891262275 | Shanda L Goecks | Registered Nurse | 6916 26th Ave, Kenosha, WI 53143 | 2018-10-24 |
1689942989 | Racine Kenosha Community Action Agency | Public Health or Welfare | 2000 63rd Street, Kenosha, WI 53143 | 2011-12-01 |
1538497797 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 7525 Sheridan Rd, Kenosha, WI 53143 | 2009-11-30 |
1497929012 | Ebba M Johnson | Physical Therapist | 524 74th Street, Kenosha, WI 53143 | 2008-04-15 |
1770789489 | Kenosha Community Health Center, Inc | Family Medicine | 6226 14th Ave, Kenosha, WI 53143 | 2007-06-21 |
1558413161 | Junith M Thompson | Obstetrics & Gynecology | 6530 Sheridan Road, Kenosha, WI 53143 | 2007-01-17 |
1154471332 | Ljh Ambulance, Inc | Ambulance | 6329 28th Ave, Kenosha, WI 53143 | 2007-01-11 |
1578625794 | Michael A Schellpfeffer Md Ob Gyn Sc | Obstetrics & Gynecology | 1400 75th Street, Kenosha, WI 53143 | 2006-12-14 |
1457468654 | Yasmine S Sido | Physician Assistant | 7550 22nd Ave, Kenosha, WI 53143 | 2006-08-24 |
1356307359 | Nancy Jane Houtchens | Dentist | 7533 22nd Ave, Ste 100, Kenosha, WI 53143 | 2006-04-26 |
Find all providers in zip 53143 |
Taxonomy Code | 207RC0000X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Internal Medicine |
Specialization | Cardiovascular Disease |
An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1295053106 | Setu D Trivedi | Internal Medicine | 10400 75th St Ste 212, Kenosha, WI 53142 | 2010-05-17 |
1043610280 | Zenith Healthcare Sc | Internal Medicine | 6121 Green Bay Rd Ste 100, Kenosha, WI 53142-2931 | 2014-08-25 |
1225156888 | Aurora Health Care Southern Lakes, Inc. | Internal Medicine | 10400 75th St, Kenosha, WI 53142 | 2007-03-26 |
1326183757 | Carroll M. Martin, M.d.,s.c. | Internal Medicine | 6308 8th Ave, Suite 3030, Kenosha, WI 53143-5031 | 2007-02-21 |
1962488965 | Katherine M Abbo | Internal Medicine | 6308 8th Ave, Ste 3060, Kenosha, WI 53143-5082 | 2005-12-21 |
1346224532 | Kevin J Fullin | Internal Medicine | 6308 8th Ave, Suite 3060, Kenosha, WI 53143-5082 | 2005-12-01 |
1609850791 | Michael C Kreager | Internal Medicine | 6308 8th Ave, Ste 3060, Kenosha, WI 53143-5082 | 2005-12-01 |
1518941707 | Drs Fullin Manda Kreager & Abbo LLC | Internal Medicine | 6308 8th Ave, Ste 3060, Kenosha, WI 53143-5082 | 2005-12-01 |
1407830698 | Ramanuja R Manda | Internal Medicine | 6308 8th Ave, Ste 3060, Kenosha, WI 53143-5082 | 2005-12-01 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1215414727 | Telemedico Physicians of Wisconsin Sc | Internal Medicine | 301 S Bedford St Ste 1, Madison, WI 53703-3691 | 2018-07-26 |
1649682667 | James King | Internal Medicine | 4540 S Sommerset Dr, New Berlin, WI 53151-6876 | 2014-05-26 |
1548686470 | Cullinane Cardiovascular Consultants, Sc | Internal Medicine | 317 N Lake Rd, Oconomowoc, WI 53066-7101 | 2014-03-17 |
1235492455 | David James Coulter | Internal Medicine | 2025 W Oklahoma Ave Ste 105, Milwaukee, WI 53215-4455 | 2012-06-21 |
1619234937 | Daniel R Harland | Internal Medicine | 2801 W Kinnickinnic River Pkwy Ste 880, Milwaukee, WI 53215-3678 | 2012-04-12 |
1336467554 | Expert Care Inc | Internal Medicine | 1111 E Sumner St, Suite A, Hartford, WI 53027-1609 | 2010-05-12 |
1548582547 | Moe Zafarani | Internal Medicine | 3215 W Lawrence St Ste 3, Appleton, WI 54914-4274 | 2010-02-18 |
1073844932 | James Harry Thomsen | Internal Medicine | 7709 Twinflower Dr, Madison, WI 53719-4544 | 2010-01-15 |
1740419019 | Thomas James Karras | Internal Medicine | 212 S Turtle Bay, Elkhart Lake, WI 53020-1985 | 2009-07-08 |
1710130216 | Bellin Memorial Hospital Inc | Internal Medicine | 208 East Reed Street, Suite B, Manitowoc, WI 54220-2121 | 2008-10-28 |
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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.