KEONA DENISE MARIE THOMPSON (NPI# 1154983922) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154983922 |
| Entity Type | Individual |
| Full Name | KEONA DENISE MARIE THOMPSON |
| Practice Address |
1121 Tall Oak Ct Racine WI 53406-3035 |
| Practice Telephone | 2629025784 |
| Mailing Telephone | 2629025784 |
| Enumeration Date | 2019-07-02 |
| Last Update Date | 2020-06-09 |
| NPI Deactivation Date | 05/11/2020 |
| NPI Reactivation Date | 2020-06-09 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NOT APPLICABLE | NONE | 01 |
| Street Address |
1121 TALL OAK CT |
| City | RACINE |
| State | WI |
| Zip Code | 53406-3035 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578164349 | Lynn Huynh | Pharmacist | 5695 Washington Ave, Racine, WI 53406 | 2020-11-06 |
| 1659920049 | Carol Jean Cornejo | Technician | 6528 Heritage Avenue, Mt Pleasant, WI 53406 | 2019-09-09 |
| 1265913958 | Mary Goldbeck | Social Worker | 1775 Newman Rd, Mt Pleasant, WI 53406 | 2018-08-22 |
| 1669963344 | Kelly Nicole Nelson | Registered Nurse | 8800 Washington Ave Ste 200, Mount Pleasant, WI 53406 | 2018-05-29 |
| 1891212163 | Ilona Agata Pryomski | Nurse Practitioner | 9201 Washington Ave, Racine, WI 53406 | 2017-08-27 |
| 1386185106 | Margaret M. Abaogye Dds | Dentist | 4340 Newman Rd., Racine, WI 53406 | 2017-03-13 |
| 1508309212 | Rebecca Koeppen | Dietitian, Registered | 8400 Washington Ave., Racine, WI 53406 | 2016-11-29 |
| 1386194371 | Forefront Dermatology, S.c. | Dermatology | 7200 Washington Ave, Suite 100, Mount Pleasant, WI 53406 | 2016-10-13 |
| 1356891402 | Forefront Dermatology, S.c. | Dermatology | 1515 S Green Bay Rd, Racine, WI 53406 | 2016-10-12 |
| 1861841470 | Leah Marie Johnson | Dentist | 1101 South Airline Road, Racine, WI 53406 | 2016-06-06 |
| Find all providers in zip 53406 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700494689 | Rebecca J Burchi | Student in an Organized Health Care Education/Training Program | 3004 Olive St, Racine, WI 53403-2826 | 2020-07-16 |
| 1093131260 | Britteny Hudzinski-hart | Student in an Organized Health Care Education/Training Program | 6905 Cliffside Dr, Racine, WI 53402-1321 | 2014-03-12 |
| 1548468507 | Rupashi Goswami | Student in an Organized Health Care Education/Training Program | 2046 Frankie Pl Apt 208, Racine, WI 53406-6113 | 2007-07-10 |
| 1306917851 | Julia Ghada Nasser | Student in an Organized Health Care Education/Training Program | 2030 Frankie Pl Apt 203, Racine, WI 53406-6117 | 2006-11-13 |
| 1154492551 | Emelide Mont-louis | Student in an Organized Health Care Education/Training Program | 4240 N Main St Apt 312, Racine, WI 53402-2885 | 2006-11-10 |
| 1972810927 | Aaron Gubi | Student in an Organized Health Care Education/Training Program | 1244 Wisconsin Ave, Racine, WI 53403-1987 | 2010-09-10 |
| 1487969226 | Carissa Geurden | Student in an Organized Health Care Education/Training Program | 1320 Wisconsin Ave, Racine, WI 53403-1978 | 2010-08-17 |
| 1487969291 | Wendy Carroll Kelly | Student in an Organized Health Care Education/Training Program | 1320 Wisconsin Ave, Racine, WI 53403-1978 | 2010-08-17 |
| 1053584219 | Meaghan Kaitlin Doherty | Student in an Organized Health Care Education/Training Program | 1320 Wisconsin Ave, Racine, WI 53403-1978 | 2008-04-09 |
| 1306035720 | Vincent R Susini | Student in an Organized Health Care Education/Training Program | 3801 Spring St, Racine, WI 53405-1667 | 2007-10-22 |
| Find all providers in RACINE | ||||
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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.