NICHOLAS JAMES HEEZEN (NPI# 1114227857) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114227857 |
| Entity Type | Individual |
| Full Name | NICHOLAS JAMES HEEZEN |
| Credential | D.O. |
| Practice Address |
2253 W Mason St Suite 200 Green Bay WI 54303-4706 |
| Practice Telephone | 9203277300 |
| Mailing Telephone | 9203277300 |
| Enumeration Date | 2010-10-28 |
| Last Update Date | 2013-02-19 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | 2009022077 | MO | Allopathic & Osteopathic Physicians |
| Street Address |
2253 W MASON ST SUITE 200 |
| City | GREEN BAY |
| State | WI |
| Zip Code | 54303-4706 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407830011 | Scott G Zahn | Pediatrics | 2253 W Mason St, Suite 200, Green Bay, WI 54303-4706 | 2005-12-06 |
| 1144869942 | Jennifer L Macgregor | Nurse Practitioner | 2253 W Mason St, Green Bay, WI 54303-4706 | 2019-12-27 |
| 1326526864 | Brooke M Fowler | Nurse Practitioner | 2253 W Mason St, Green Bay, WI 54303 | 2018-08-06 |
| 1134646557 | Samantha J Grigg | Physician Assistant | 2253 W Mason St, Green Bay, WI 54303-4706 | 2017-08-25 |
| 1003331125 | Nicole L Lowe | Nurse Practitioner | 2253 W Mason St, Green Bay, WI 54303-4706 | 2017-08-09 |
| 1487178810 | Allie E Loewe | Physician Assistant | 2253 W Mason St, Green Bay, WI 54303-4706 | 2017-07-27 |
| 1598115289 | Elizabeth Marie Congdon | Optometrist | 2253 W Mason St, #100, Green Bay, WI 54303-4706 | 2016-06-14 |
| 1982916524 | Laura J Schroeder | Physician Assistant | 2253 W Mason St, Suite 200, Green Bay, WI 54303-4706 | 2010-07-12 |
| 1134440670 | William Joseph Reynders | Ophthalmology | 2253 W Mason St, Green Bay, WI 54303 | 2010-06-18 |
| 1306161799 | Lara Sutton | Occupational Therapist | 2253 W Mason St, Green Bay, WI 54303-4706 | 2010-03-29 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952921033 | Ashley Marie Vandermoss | Social Worker | 1601 W Mason Street, Green Bay, WI 54303 | 2020-04-20 |
| 1598307423 | Jean Marie Castaneda | Case Manager/Care Coordinator | 2517 N. Court, Green Bay, WI 54303 | 2019-10-11 |
| 1215579552 | Integrated Treatment Centers, LLC | Clinic/Center | 2311 W Mason Street, Green Bay, WI 54303 | 2019-10-08 |
| 1003460551 | Affordable Dentures & Implants - Green Bay, S.c. | Dentist | 1800-c W. Mason Street, Green Bay, WI 54303 | 2019-08-01 |
| 1164940375 | Kaeley Rae Blaney | Student in an Organized Health Care Education/Training Program | 2088 Memorial Drive #208, Green Bay, WI 54303 | 2017-09-07 |
| 1518498047 | Treatment Providers LLC | Clinic/Center | 2731 N Packerland Dr Ste A, Green Bay, WI 54303 | 2017-03-26 |
| 1851840565 | Back To Balance Chiropractic, LLC | Chiropractor | 110 Packerland Drive, Suite B, Green Bay, WI 54303 | 2016-09-23 |
| 1710361001 | Matthew Lemay | Acupuncturist | 727 E Walnut, Suite B2, Green Bay, WI 54303 | 2015-07-16 |
| 1144600149 | Carrie Jean Banaszak | Counselor | 1039 Mason Street, Green Bay, WI 54303 | 2015-06-04 |
| 1174921993 | Kensey Meyer | Occupational Therapy Assistant | 1555 Dousman Road, Seymour, WI 54303 | 2014-12-10 |
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| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://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 |
|---|---|---|---|---|
| 1922349927 | John W Hartman | Internal Medicine | 916 Willard Dr, Suite 200, Green Bay, WI 54304 | 2013-03-15 |
| 1891061446 | Riley O'hara Meyer | Internal Medicine | 401 N. Washington St., #315, Green Bay, WI 54301 | 2012-03-28 |
| 1811121023 | Kevin Peter Rosteing | Internal Medicine | 2126 William Francis Ct, Green Bay, WI 54311-6352 | 2009-05-04 |
| 1225118235 | Imran R Sheikh | Internal Medicine | 1320 Crystal Cove Trl, Apt 2, Green Bay, WI 54311-4292 | 2006-10-16 |
| 1952418386 | Gowdar Sadishiv Murthy | Internal Medicine | 3000 Ravine Way, Green Bay, WI 54301-1507 | 2006-08-23 |
| 1265452296 | Sheila Waldrop Thiel | Internal Medicine | 2845 Greenbrier Rd Ste 120, Green Bay, WI 54311-6519 | 2006-07-20 |
| 1780644666 | Vijaya K Munagala | Internal Medicine | 744 S Webster Ave Fl 2, Green Bay, WI 54301-3505 | 2006-03-24 |
| 1992774160 | Thomas Joseph Leonard | Internal Medicine | 2763 Manitowoc Rd, Suite B, Green Bay, WI 54311-6633 | 2006-03-17 |
| 1497721054 | Patricia Elizabeth Sias | Internal Medicine | 1715 Dousman St., Green Bay, WI 54303-3211 | 2006-02-24 |
| 1780671792 | Kathleen Ann Mcdougal | Internal Medicine | 3021 Voyager Dr, Green Bay, WI 54311-8303 | 2005-10-04 |
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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.