DR. KENNETH J. LISBERG (NPI# 1144298878) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144298878 |
| Entity Type | Individual |
| Full Name | DR. KENNETH J. LISBERG |
| Credential | M.D. |
| Practice Address |
2920 Superior Ave Sheboygan WI 53081-1944 |
| Practice Telephone | 9204524911 |
| Practice Fax Number | 9204583163 |
| Mailing Telephone | 9204524911 |
| Mailing Fax Number | 9204583163 |
| Enumeration Date | 2006-03-09 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208600000X | Surgery | 18543 | WI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 30309500 | 05 |
| Street Address |
2920 SUPERIOR AVE |
| City | SHEBOYGAN |
| State | WI |
| Zip Code | 53081-1944 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780672394 | D Scott Sellinger | Orthopaedic Surgery | 2920 Superior Ave, Sheboygan, WI 53081-1944 | 2005-10-07 |
| 1407322183 | Alyssa Pfeifer-rentmeester | Physician Assistant | 2920 Superior Ave, Sheboygan, WI 53081-1944 | 2018-10-19 |
| 1235622523 | Jacqueline Mary Caelwarts | Physician Assistant | 2920 Superior Ave, Sheboygan, WI 53081-1944 | 2018-06-11 |
| 1710415427 | Amanda Gumm | Physical Therapist | 2920 Superior Ave, Sheboygan, WI 53081-1944 | 2017-05-24 |
| 1104374388 | Amanda Henschel | Physical Therapist | 2920 Superior Ave, Sheboygan, WI 53081-1944 | 2016-09-15 |
| 1831552256 | Matthew Hemsing | Internal Medicine | 2920 Superior Ave, Sheboygan, WI 53081 | 2016-04-02 |
| 1831591270 | Jessica Murphy | Nurse Practitioner | 2920 Superior Ave, Sheboygan, WI 53081-1944 | 2014-09-17 |
| 1831590264 | Amanda Strong | Nurse Practitioner | 2920 Superior Ave, Suite 110, Sheboygan, WI 53081-1944 | 2014-09-04 |
| 1801217328 | St Nicholas Hospital-sisters of The Third Order of St Francis | Durable Medical Equipment & Medical Supplies | 2920 Superior Ave, Sheboygan, WI 53081-1944 | 2013-12-31 |
| 1477819902 | Sheboygan Physicians Group, Sc | Internal Medicine | 2920 Superior Ave, Sheboygan, WI 53081-1944 | 2012-04-10 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770053696 | Kathy Hughes Counseling, LLC | Community/Behavioral Health | 630 Riverfront Dr Ste 203, Sheboygan, WI 53081 | 2018-12-04 |
| 1780159004 | Great Lakes Clinic and Consultants, LLC | Clinic/Center | 1407 North 8th Street, Suite 203, Sheboygan, WI 53081 | 2018-10-13 |
| 1174032106 | Laura Elizabeth Manning | Registered Nurse | 325 Linocln Ave, Sheboygan, WI 53081 | 2017-09-21 |
| 1043733686 | Chasidy D Wilke | Behavioral Analyst | 2223 Terrace View Dr Apt 3a, Sheboygan, WI 53081 | 2017-07-25 |
| 1700320074 | Darlene Wilken | Counselor | 2842 S. Business Dr, Sheboygan, WI 53081 | 2016-12-06 |
| 1942652185 | Jacob Steven Son | Dentist | 3555 Wasington Ave., Sheboygan, WI 53081 | 2016-07-12 |
| 1225491749 | Cassandra Lea Loehndorf | Social Worker | 3321 S. 12th St., Sheboygan, WI 53081 | 2016-04-01 |
| 1003201112 | Jason Meinhardt | Dentist | 2115 S Memorial Pl, Sheboygan, WI 53081 | 2015-04-06 |
| 1346634110 | Christopher Lenz | Specialist/Technologist | 2920 Superior Ave., Prevea Orthopedics, Sheboygan, WI 53081 | 2015-03-19 |
| 1780008060 | James Simac | Counselor | 503 Wisconsin Ave., Sheboygan, WI 53081 | 2014-02-07 |
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| Taxonomy Code | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245632389 | Jordan Peter Makela | Surgery | 3113 Saemann Ave, Sheboygan, WI 53081 | 2014-09-19 |
| 1811283526 | William Ritt | Surgery | 2414 Kohler Memorial Dr, Sheboygan, WI 53081-3129 | 2011-06-21 |
| 1912136656 | Brian John Obrochta | Surgery | 2629 N 7th St, Sheboygan, WI 53083-4932 | 2009-07-02 |
| 1902031909 | Nicholas John Draeger | Surgery | 2414 Kohler Memorial Dr, Sheboygan, WI 53081-3129 | 2009-05-19 |
| 1972629145 | Sheboygan Surgical Associates, S.c. | Surgery | 2920 Superior Ave, Sheboygan, WI 53081-1944 | 2007-03-21 |
| 1285703744 | Christopher Alan Garces | Surgery | 2920 Superior Ave, Sheboygan, WI 53081-1944 | 2006-11-07 |
| 1154436244 | Badri N Ganju | Surgery | 2414 Kohler Memorial Dr, Sheboygan, WI 53081 | 2006-08-20 |
| 1851300982 | William P Chleborad | Surgery | 2414 Kohler Memorial Dr, Sheboygan, WI 53081 | 2006-08-07 |
| 1295703635 | Stephen J. Werner | Surgery | 2920 Superior Ave, Sheboygan, WI 53081-1944 | 2006-03-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598310195 | Matthew Laviolette | Surgery | Medical College of Wisconsin, 8701 Watertown Plank Rd., Surgical Oncology, Milwaukee, WI 53226 | 2019-08-09 |
| 1659832855 | Benjamin David Seadler | Surgery | Mcw, Department of Surgery, 8701 Watertown Plank Road, Milwaukee, WI 53226 | 2019-03-29 |
| 1861969149 | Watertown Physician Practices LLC | Surgery | 123 Hospital Dr Ste 2009, Watertown, WI 53098-3320 | 2018-10-25 |
| 1356847644 | Laura K Krecko | Surgery | Uw Hospital and Clinics 600 Highland Avenue, Madison, WI 53792-0001 | 2018-04-04 |
| 1447785332 | Patrick Beard Schwartz | Surgery | Uw Hopsitals and Clinics, 600 Highland Ave., Madison, WI 53792-0001 | 2017-04-27 |
| 1700263720 | Marianna Dubovska | Surgery | 902 Riverside Dr Ste 201, Waupaca, WI 54981-1992 | 2015-04-28 |
| 1366833394 | Beaver Dam Community Hospitals, Inc | Surgery | 705 S University Ave Ste 350, Beaver Dam, WI 53916 | 2015-02-12 |
| 1972901262 | The Healthy Vein, Sc | Surgery | N79w14684 Appleton Ave, Menomonee Falls, WI 53051-4308 | 2014-12-18 |
| 1326453200 | Chey V Collura | Surgery | 2700 W 9th Ave Ste 310, Oshkosh, WI 54904 | 2014-06-30 |
| 1538570338 | Nicholas Sich | Surgery | 2901 W Kinnickinnic River Pkwy Dept Ste 540, Milwaukee, WI 53215-3677 | 2014-05-14 |
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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.