JACOB N CLENDENON


Address: 2801 W Kinnickinnic River Pkwy, Suite 530, Milwaukee, WI 53215-3669
Phone: 4146495534

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).

Provider Overview

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

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 204F00000X Transplant Surgery 56155-20 WI Allopathic & Osteopathic Physicians

Office Location

Street Address 2801 W KINNICKINNIC RIVER PKWY
SUITE 530
City MILWAUKEE
State WI
Zip Code 53215-3669

Providers in the same location

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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Providers in the same zip code

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
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Taxonomy Information

Taxonomy Code 204F00000X
Grouping Allopathic & Osteopathic Physicians
Classification Transplant Surgery

Taxonomy Definition

Definition to come.

Providers in the same taxonomy and city

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
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Competitor

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City MILWAUKEE
Zip Code 53215

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Dataset Information

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.

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