DR. RICHARD P THIEDE (NPI# 1154421865) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154421865 |
| Entity Type | Individual |
| Full Name | DR. RICHARD P THIEDE |
| Credential | M.D. |
| Practice Address |
2323 N Lake Dr Milwaukee WI 53211-4508 |
| Mailing Address |
4425 N Port Washington Rd Department of Internal Medicine Milwaukee WI 53212-1082 |
| Practice Telephone | 4142704932 |
| Mailing Telephone | 4143262218 |
| Enumeration Date | 2006-09-23 |
| Last Update Date | 2014-09-10 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RG0300X |
Internal Medicine Specialization: Geriatric Medicine |
62929 | WI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 4644006 | 05 |
| Street Address |
2323 N LAKE DR |
| City | MILWAUKEE |
| State | WI |
| Zip Code | 53211-4508 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225032691 | Rosemary S Presser | Nurse Practitioner | 2323 N Lake Dr, 7th Floor, Milwaukee, WI 53211-4508 | 2005-06-13 |
| 1205434404 | Emma Stocker | Genetic Counselor, MS | 2323 N Lake Dr, Milwaukee, WI 53211-4508 | 2020-10-12 |
| 1669070876 | Hannah Brodner | Genetic Counselor, MS | 2323 N Lake Dr, Milwaukee, WI 53211-4508 | 2020-10-12 |
| 1598378531 | Sandra Luz Chapa | Registered Nurse | 2323 N Lake Dr, Milwaukee, WI 53211-4508 | 2020-08-28 |
| 1295347227 | Sarah Purpura | Dietitian, Registered | 2323 N Lake Dr, Milwaukee, WI 53211-4508 | 2020-08-20 |
| 1780205450 | Kyra Gravelle | Occupational Therapist | 2323 N Lake Dr, Milwaukee, WI 53211-4508 | 2020-05-04 |
| 1780213223 | Andrew Michael Ganshirt | Student in an Organized Health Care Education/Training Program | 2323 N Lake Dr, Milwaukee, WI 53211-4508 | 2020-04-06 |
| 1386290872 | Mary R Laquerre | Anesthesiologist Assistant | 2323 N Lake Dr, Milwaukee, WI 53211-4508 | 2019-08-12 |
| 1346721669 | Rochelle F Hass | Physician Assistant | 2323 N Lake Dr, Milwaukee, WI 53211-4508 | 2018-08-24 |
| 1053800714 | Heather Jean Biancuzzo | Pharmacist | 2323 N Lake Dr, Milwaukee, WI 53211-4508 | 2018-05-08 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821602335 | Gabriella Caitrin Emanuele | Occupational Therapist | Harborchase of Shorewood, 1111 E Capitol Drive, Shorewood, WI 53211 | 2020-09-02 |
| 1710527783 | Sage Specialty Pharmacy Inc. | Pharmacy | 4001 N. Oakland Ave, Shorewood, WI 53211 | 2020-01-08 |
| 1861043952 | Rosina Bloomingdale Norton | Nurse Practitioner | 1921 E Harford Ave, Milwaukee, WI 53211 | 2019-09-20 |
| 1528556255 | Renee Reckelberg | Specialist/Technologist | 3409 North Downer Avenue, Pavilion, Suite 350, Milwaukee, WI 53211 | 2018-04-27 |
| 1700325602 | Wisconsin Vision, Inc. | Optometrist | 4163 N Oakland Ave, Shorewood, WI 53211 | 2017-02-13 |
| 1750827556 | Daniel Butz M.d., S.c. | Plastic Surgery | 2350 N Lake Dr Ste 304, Milwaukee, WI 53211 | 2017-01-17 |
| 1528517232 | Therese Simonis | Speech-Language Pathologist | 2390 N Lake Drive, Milwaukee, WI 53211 | 2016-09-23 |
| 1982075701 | Katie Michel | Specialist/Technologist | 3409 N. Downer Ave, Milwaukee, WI 53211 | 2015-10-20 |
| 1255776365 | Sarah Elizabeth Brill | Social Worker | 4433 N Oakland Ave Ste D, Shorewood, WI 53211 | 2013-05-02 |
| 1679814537 | Nicole Anne Parulski | Physical Therapist | 2301 North Lake Dr, Milwaukee, WI 53211 | 2013-03-01 |
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| Taxonomy Code | 207RG0300X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Geriatric Medicine |
| An internist who has special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes and the hospital. |
| 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 |
|---|---|---|---|---|
| 1003882994 | Soryal A Soryal | Internal Medicine | 1020 N 12th St, 3rd Floor, Milwaukee, WI 53233-1308 | 2006-02-28 |
| 1720407893 | Cara Coughlin O'brien | Internal Medicine | 9200 W Wisconsin Ave, Milwaukee, WI 53226 | 2014-04-15 |
| 1063839397 | Elizabeth Ann Bukowy | Internal Medicine | 9200 W Wisconsin Ave, Specialty Clinics Building, 4th Floor, Milwaukee, WI 53226-3522 | 2014-03-25 |
| 1275890568 | Laura Ann Previll | Internal Medicine | 8701 W Watertown Plank Rd, Milwaukee, WI 53226-3548 | 2012-04-12 |
| 1518261510 | Zaw Moe Aung | Internal Medicine | 8520 W Oklahoma Ave, Milwaukee, WI 53227-4604 | 2011-01-05 |
| 1972762979 | Alina M Petculescu | Internal Medicine | 8520 W Oklahoma Ave, Milwaukee, WI 53227-4604 | 2008-06-04 |
| 1053469536 | Michael L Malone | Internal Medicine | 1020 N 12th St, 3rd Floor, Milwaukee, WI 53233-1308 | 2007-01-08 |
| 1205991254 | Tyler H Steward | Internal Medicine | 2900 W Oklahoma Ave, Milwaukee, WI 53215-4330 | 2006-12-27 |
| 1144310475 | Kalluru Vijayabhanu | Internal Medicine | 5228 W Fond Du Lac Ave, Milwaukee, WI 53216 | 2006-10-16 |
| 1861582215 | Marilyn J Sincaban | Internal Medicine | 1555 S Layton Blvd, Milwaukee, WI 53215-1924 | 2006-10-14 |
| Find all providers in MILWAUKEE | ||||
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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.