SHAWN C. EKSTROM (NPI# 1134120033) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134120033 |
| Entity Type | Individual |
| Full Name | SHAWN C. EKSTROM |
| Credential | MD |
| Practice Address |
777 Algoma Blvd Radford Hall Oshkosh WI 54901-3534 |
| Practice Telephone | 9204242424 |
| Practice Fax Number | 9204241769 |
| Mailing Telephone | 9204242424 |
| Mailing Fax Number | 9204241769 |
| Enumeration Date | 2005-08-02 |
| Last Update Date | 2015-06-15 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 36923-020 | WI | Allopathic & Osteopathic Physicians |
| N | 208600000X | Surgery | 36923-020 | WI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 322111700 | 05 |
| Street Address |
777 ALGOMA BLVD RADFORD HALL |
| City | OSHKOSH |
| State | WI |
| Zip Code | 54901-3534 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689024655 | Brent Robert Macwilliams | Nurse Practitioner | 777 Algoma Blvd, Oshkosh, WI 54901-3534 | 2016-06-20 |
| 1528460839 | Kristi Ziolkowski | Nurse Practitioner | 777 Algoma Blvd, Radford Hall, Student Health Center, Oshkosh, WI 54901-3534 | 2014-09-17 |
| 1215336730 | Rebecca Rose Hoerth | Nurse Practitioner | 777 Algoma Blvd, Oshkosh, WI 54901-3534 | 2014-08-20 |
| 1366871634 | Sally Andersen | Nurse Practitioner | 777 Algoma Blvd, Oshkosh, WI 54901-3534 | 2013-11-06 |
| 1790031102 | Angela Hawley | Nurse Practitioner | 777 Algoma Blvd, Oshkosh, WI 54901-3534 | 2012-08-03 |
| 1932322104 | John Mcandrew | Psychiatry & Neurology | 777 Algoma Blvd, Radford Hall, Oshkosh, WI 54901-3534 | 2007-04-10 |
| 1407079684 | Penny Howell | Registered Nurse | 777 Algoma Blvd, Radford Hall, Oshkosh, WI 54901-3534 | 2007-04-10 |
| 1336168798 | Robert L. Weston | Internal Medicine | 777 Algoma Blvd, Oshkosh, WI 54901-3534 | 2006-07-18 |
| 1497774830 | Mary Gwen Steffen | Registered Nurse | 777 Algoma Blvd, Oshkosh, WI 54901-3534 | 2006-07-18 |
| 1174509038 | Maria Wolf | Nurse Practitioner | 777 Algoma Blvd, Radford Hall, Oshkosh, WI 54901-3534 | 2005-12-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023657855 | Kayla Crockett | Specialist/Technologist | Kolf Sports Center, Oshkosh, WI 54901 | 2019-12-26 |
| 1629593421 | Taymoor Sardar | Psychologist | 404 N. Main St., Suite 501, Oshkosh, WI 54901 | 2017-08-14 |
| 1821414889 | Chris Lynn Wiggs | Registered Nurse | 2150 Ontario St., Oshkosh, WI 54901 | 2014-03-13 |
| 1114359023 | Robert James Rigoni Jr. | Pharmacist | 1300 S. Koeller Rd, Oshkosh, WI 54901 | 2013-08-01 |
| 1427313386 | Scott Forrest Trippe | Psychologist | 627 Bayshore Drive, Oshkosh, WI 54901 | 2012-07-06 |
| 1003113135 | Ashley Lauren Procknow | Registered Nurse | 105 Bowen St, Oshkosh, WI 54901 | 2011-02-25 |
| 1982915963 | Benjamin Ross Goldstein | Psychiatry & Neurology | 4100 Treffert Dr., Oshkosh, WI 54901 | 2010-06-24 |
| 1982926234 | Patricia A Pendowski | Counselor | 3240 Jackson Street, Oshkosh, WI 54901 | 2010-02-26 |
| 1083867477 | Lori Marie Pierquet | Psychologist | 375 C Executive Suites, City Center, Oshkosh, WI 54901 | 2008-10-29 |
| 1346493228 | William Alexander Hammond | Dentist | 5252 I-ah-maytah Rd., Oshkosh, WI 54901 | 2008-10-23 |
| Find all providers in zip 54901 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215033972 | Dilip Kumar Tannan | Family Medicine | 555 S Washburn St, Cte 2, Oshkosh, WI 54904-6710 | 2006-09-16 |
| 1063421683 | Scott J Beougher | Family Medicine | 5165 Chesapeake Ct, Oshkosh, WI 54901-1329 | 2006-08-05 |
| 1891704417 | Kristin P Beougher | Family Medicine | 5169 Chesapeake Ct, Oshkosh, WI 54901 | 2006-08-05 |
| 1063406973 | Harold W Boccheciamp | Family Medicine | 2725 Jackson St, Oshkosh, WI 54901-1513 | 2005-09-07 |
| 1336639202 | Kassondra K Korth | Family Medicine | 1855 S Koeller St, Oshkosh, WI 54902-6186 | 2018-05-15 |
| 1134641384 | George M Lessmann | Family Medicine | 135 Jackson St, Oshkosh, WI 54901-4713 | 2017-07-10 |
| 1568994853 | Sarah Wypiszynski | Family Medicine | 1855 S Koeller St, Oshkosh, WI 54902-6186 | 2017-03-28 |
| 1346624178 | Emily Favret | Family Medicine | 500 S Oakwood Rd, Oshkosh, WI 54904 | 2015-07-10 |
| 1336552280 | Regional West Garden County | Family Medicine | 1100 W 2nd St, Ste 100, Oshkosh, NE 69154-6152 | 2014-06-09 |
| 1598183089 | Katherine Nonweiler | Family Medicine | 2725 Jackson St, Oshkosh, WI 54901-1513 | 2014-04-01 |
| Find all providers in OSHKOSH | ||||
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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.