ALAN W ROETKER (NPI# 1124119110) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124119110 |
| Entity Type | Individual |
| Full Name | ALAN W ROETKER |
| Credential | MD |
| Practice Address |
421 Camelot Dr Fond Du Lac WI 54935-8335 |
| Mailing Address |
420 E Division St Fond Du Lac WI 54935-4560 |
| Practice Telephone | 9209268616 |
| Mailing Telephone | 9209268340 |
| Mailing Fax Number | 9209268370 |
| Enumeration Date | 2006-09-27 |
| Last Update Date | 2016-03-02 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207X00000X | Orthopaedic Surgery | 26029 | WI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | RAILROAD MEDICARE | P00861894 | 01 |
| WI | 31386600 | 05 |
| Street Address |
421 CAMELOT DR |
| City | FOND DU LAC |
| State | WI |
| Zip Code | 54935-8335 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366433435 | Elizabeth S Bensen | Physical Medicine & Rehabilitation | 421 Camelot Dr, Fond Du Lac, WI 54935-8335 | 2005-10-28 |
| 1962028522 | Kelley Cantu | Massage Therapist | 421 Camelot Dr, Fond Du Lac, WI 54935-8335 | 2020-06-19 |
| 1306473780 | Samantha Jo Krones | Physician Assistant | 421 Camelot Dr, Fond Du Lac, WI 54935-8335 | 2020-03-25 |
| 1962975292 | Tyler Schwarz | Specialist/Technologist | 421 Camelot Dr, Fond Du Lac, WI 54935-8335 | 2019-01-09 |
| 1154808491 | Greta Marie Breckbill | Audiologist | 421 Camelot Dr, Fond Du Lac, WI 54935 | 2018-07-19 |
| 1861991424 | Jacklyn Osborne | Nurse Practitioner | 421 Camelot Dr, Fond Du Lac, WI 54935-8335 | 2018-02-08 |
| 1932620689 | Michael Schraufnagel | Physical Therapist | 421 Camelot Dr, Fond Du Lac, WI 54935-8335 | 2017-07-03 |
| 1477083608 | Tristan G Brown | Optometrist | 421 Camelot Dr, Fond Du Lac, WI 54935-8335 | 2017-06-20 |
| 1306379433 | Ashley Beyer | Specialist/Technologist | 421 Camelot Dr, Fond Du Lac, WI 54935-8335 | 2017-04-05 |
| 1417498254 | Allieson Elizabeth Mirsberger | Massage Therapist | 421 Camelot Dr, Fond Du Lac, WI 54935-8335 | 2017-03-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609482249 | Keziah Sherri Love | Counselor | W390 Wi-23, Fond Du Lac, WI 54935 | 2020-09-18 |
| 1891341988 | Cynthia Louise Singleton | Nurse Practitioner | 16 E 13th St., Fond Du Lac, WI 54935 | 2019-08-14 |
| 1083183297 | Elena Alexandra Giese | Nurse Practitioner | 430 E. Division St, Fond Du Lac, WI 54935 | 2018-11-16 |
| 1669963740 | Elizabeth Anne Machi | Student in an Organized Health Care Education/Training Program | 885 Western Ave Ste 300, Fond Du Lac, WI 54935 | 2018-05-23 |
| 1184150021 | Jordan Moehn | Specialist/Technologist | 633 Prairie Pkwy, Fond Du Lac, WI 54935 | 2017-05-11 |
| 1467856336 | Chuentao Ho | Specialist/Technologist | 45 South National Ave., Fond Du Lac, WI 54935 | 2014-10-21 |
| 1437587961 | Paula Seeley | Nurse Practitioner | 63 West Pioneer Rd, Fond Du Lac, WI 54935 | 2013-10-18 |
| 1144516030 | Bonnie Kay Mallon | Registered Nurse | 118 E 9th St, Fond Du Lac, WI 54935 | 2011-06-20 |
| 1770885600 | Holly Shepard | Counselor | 23 W Scott St., Fond Du Lac, WI 54935 | 2010-11-29 |
| 1437479110 | Ruth Marie Bohn | Occupational Therapy Assistant | 244 North Macy Street, Fond Du Lac, WI 54935 | 2010-06-04 |
| Find all providers in zip 54935 | ||||
| Taxonomy Code | 207X00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. American Osteopathic Board of Orthopaedic Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Orthopaedic Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073743472 | Bryan Royce | Orthopaedic Surgery | 421 Camelot Dr, Fond Du Lac, WI 54935-8335 | 2009-07-20 |
| 1447492590 | Luke T Fraundorf | Orthopaedic Surgery | 421 Camelot Dr, Fond Du Lac, WI 54935-8335 | 2009-04-02 |
| 1205927282 | Glen J Kemp Jr. | Orthopaedic Surgery | 421 Camelot Dr, Fond Du Lac, WI 54935-8335 | 2006-09-27 |
| 1437240421 | Clinic of Orthopedic Surgery Chtd | Orthopaedic Surgery | 210 Wisconsin American Dr, Ste 235, Fond Du Lac, WI 54935-2999 | 2006-09-27 |
| 1851366645 | Clark Pomeroy Searle IIi | Orthopaedic Surgery | 421 Camelot Dr, Fond Du Lac, WI 54935-8335 | 2006-02-23 |
| 1841272994 | Michael D Mannebach | Orthopaedic Surgery | 421 Camelot Dr, Fond Du Lac, WI 54935-8335 | 2005-11-15 |
| 1487636536 | Karl Pennau | Orthopaedic Surgery | 421 Camelot Dr, Fond Du Lac, WI 54935-4560 | 2005-11-15 |
| 1871575076 | Steven A Magoline | Orthopaedic Surgery | 421 Camelot Dr, Fond Du Lac, WI 54935-8335 | 2005-11-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700486602 | Butler Orthopedics, LLP | Orthopaedic Surgery | 3237 S 16th St Ste 210, Milwaukee, WI 53215-4526 | 2020-10-29 |
| 1831729276 | Aspen Orthopedic and Rehabilation Specalist | Orthopaedic Surgery | 8907 S Howell Ave Ste 800, Oak Creek, WI 53154-4461 | 2020-01-24 |
| 1710520200 | Aspen Orthopedic and Rehabilation Specalist | Orthopaedic Surgery | 12555 W National Ave Ste 100, New Berlin, WI 53151-4061 | 2019-10-28 |
| 1477015931 | Multiple Care of Wi II, LLC | Orthopaedic Surgery | 8040 Excelsior Dr Ste 400, Madison, WI 53717-2915 | 2019-04-03 |
| 1508321209 | Ellen M Obrien | Orthopaedic Surgery | 5026 N Northwood Trce, Janesville, WI 53545-8990 | 2019-02-06 |
| 1487180238 | Ryan Scott Bailey | Orthopaedic Surgery | 7708 Milwaukee Ave, Wauwatosa, WI 53213-2209 | 2017-05-11 |
| 1932584927 | Anne Margarethe Ryan | Orthopaedic Surgery | 5940 Wild Rose Ln, Eau Claire, WI 54701-8783 | 2015-07-20 |
| 1003202631 | Bellin Memorial Hospital Inc | Orthopaedic Surgery | 218 So Hwy 141, Crivitz, WI 54114-1636 | 2015-04-10 |
| 1952728206 | Jacob R Seiler | Orthopaedic Surgery | 1205 West American Drive, Neenah, WI 54956-1405 | 2014-03-25 |
| 1770920472 | Jonathan Stone | Orthopaedic Surgery | 3111 W Rawson Ave Ste 200205, Franklin, WI 53132-9417 | 2013-06-04 |
| Find all providers with the same taxonomy | ||||
| City | FOND DU LAC |
| Zip Code | 54935 |
Please comment or provide details below to improve the information on ALAN W ROETKER.
| 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.