JACOB N CLENDENON (NPI# 1093959231) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1093959231 |
Entity Type | Individual |
Full Name | JACOB N CLENDENON |
Credential | MD |
Practice Address |
2801 W Kinnickinnic River Pkwy Suite 530 Milwaukee WI 53215-3669 |
Practice Telephone | 4146495534 |
Mailing Telephone | 4146495534 |
Enumeration Date | 2009-04-30 |
Last Update Date | 2011-11-08 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 204F00000X | Transplant Surgery | 56155-20 | WI | Allopathic & Osteopathic Physicians |
Street Address |
2801 W KINNICKINNIC RIVER PKWY SUITE 530 |
City | MILWAUKEE |
State | WI |
Zip Code | 53215-3669 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1215930391 | Anthony C Defranco | Internal Medicine | 2801 W Kinnickinnic River Pkwy, Suite 840, Milwaukee, WI 53215-3669 | 2005-05-23 |
1114530987 | Michelle A Krueger | Nurse Practitioner | 2801 W Kinnickinnic River Pkwy, Milwaukee, WI 53215-3669 | 2020-08-31 |
1538772397 | Nicholas J Kajdan | Registered Nurse | 2801 W Kinnickinnic River Pkwy, Milwaukee, WI 53215-3669 | 2020-08-31 |
1376184549 | Alix Mertens | Physician Assistant | 2801 W Kinnickinnic River Pkwy, Milwaukee, WI 53215 | 2019-09-30 |
1235789363 | Andrea S Ganzke | Nurse Practitioner | 2801 W Kinnickinnic River Pkwy, Milwaukee, WI 53215-3669 | 2019-09-20 |
1003461336 | Vanja Z Rissky | Nurse Practitioner | 2801 W Kinnickinnic River Pkwy, Milwaukee, WI 53215-3669 | 2019-08-05 |
1881246346 | Kevin Nehil | Physician Assistant | 2801 W Kinnickinnic River Pkwy, Milwaukee, WI 53215-3669 | 2019-07-15 |
1295387975 | Ann M Mayer | Nurse Practitioner | 2801 W Kinnickinnic River Pkwy, Milwaukee, WI 53215-3669 | 2019-07-12 |
1265994727 | Rachel Krueger | Occupational Therapist | 2801 W Kinnickinnic River Pkwy, Milwaukee, WI 53215-3669 | 2019-04-03 |
1518446707 | Cailin K Loose | Nurse Practitioner | 2801 W Kinnickinnic River Pkwy, Milwaukee, WI 53215-3669 | 2018-08-09 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1841829918 | Joshua Michael Brooks | Student in an Organized Health Care Education/Training Program | Aurora St. Lukes Medical Center 2901 W Oklahoma Ave, Milwaukee, WI 53215 | 2020-04-02 |
1053967091 | Kristina Strupp | Clinical Nurse Specialist | 2900 W. Oaklahoma Avenue, Milwaukee, WI 53215 | 2019-08-15 |
1427510296 | Madelyn Pickle | Student in an Organized Health Care Education/Training Program | 2801 W. Kinnickinnic Rd Ste 250, Milwaukee, WI 53215 | 2019-04-02 |
1932601838 | Elizabeth D Morawski | Nurse Practitioner | 2801 Kinnickinnic Parkway, Suite 630, Milwaukee, WI 53215 | 2018-03-06 |
1457872673 | Canzata Kimberly Dent | Counselor | 2727 W. Cleveland Suite 204, Milwaukee, WI 53215 | 2017-06-28 |
1538689955 | Christian Pena | Durable Medical Equipment & Medical Supplies | 2800 W Forest Home Ave, Suite 100, Milwaukee, WI 53215 | 2017-06-27 |
1386178804 | Dane A Olsen | Family Medicine | 801 W Kinnickinnic River Pkwy., Suite 250, Milwaukee, WI 53215 | 2017-04-12 |
1811443492 | Thomas Diamond | Physical Therapist | 2901 Kinnickinnic Parkway, Milwaukee, WI 53215 | 2016-09-01 |
1487055133 | Sam Khalili | Otolaryngology | 2801 W Kinnickinnic River Pkwy # 680, Milwaukee, WI 53215 | 2014-09-12 |
1992105621 | Nicole R Hall | Nurse Practitioner | 2901 S Kinnickinnic Ave, Milwaukee, WI 53215 | 2014-08-29 |
Find all providers in zip 53215 |
Taxonomy Code | 204F00000X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Transplant Surgery |
Definition to come. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1457788564 | Gaurav Jain | Transplant Surgery | 2900 W Oklahoma Ave, Milwaukee, WI 53215-4330 | 2013-10-03 |
1578827820 | Priyal Patel | Transplant Surgery | 9200 W Wisconsin Ave, Milwaukee, WI 53226-3522 | 2012-07-02 |
1407144686 | Joohyun Kim | Transplant Surgery | 9200 W Wisconsin Ave, Suite E5700, Mcw Transplant Surgery, Milwaukee, WI 53226-3522 | 2011-07-21 |
1316268477 | Melissa Wong | Transplant Surgery | 9200 W Wisconsin Avenue, Transplant Surgery, Milwaukee, WI 53226-3522 | 2010-06-11 |
1962645176 | Motaz Selim | Transplant Surgery | 9200 W Wisconsin Ave, Transplant Surgery, Milwaukee, WI 53226-3522 | 2009-04-17 |
1194967000 | Calvin Eriksen | Transplant Surgery | 9200 W Wisconsin Ave, Transplant Surgery, Milwaukee, WI 53226-3522 | 2009-03-24 |
1730320912 | Terra Renee Pearson | Transplant Surgery | 9200 W Wisconsin Ave, Transplant Surgery, Milwaukee, WI 53226 | 2009-03-17 |
1396991857 | Gelu Osian | Transplant Surgery | 9200 W Wisconsin Ave, Milwaukee, WI 53226-3522 | 2008-08-14 |
1245377233 | Ajay K Sahajpal | Transplant Surgery | 2900 W Oklahoma Ave, 5th Fl Galleria, Milwaukee, WI 53215-4330 | 2007-01-31 |
1427070010 | Francisco Antonio Durazo | Transplant Surgery | 9200 W Wisconsin Ave, Milwaukee, WI 53226-3522 | 2006-07-24 |
Find all providers in MILWAUKEE |
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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.