RACINE EMERGENCY PHYSICIANS, S.C. (NPI# 1184654121) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184654121 |
| Entity Type | Organization |
| Organization Name | RACINE EMERGENCY PHYSICIANS, S.C. |
| Practice Address |
3801 Spring St Racine WI 53405-1667 |
| Mailing Address |
3805b Spring St Suite 230 Racine WI 53405-1641 |
| Practice Telephone | 2626874201 |
| Practice Fax Number | 2626875375 |
| Mailing Telephone | 2626874479 |
| Mailing Fax Number | 2626875375 |
| Enumeration Date | 2006-07-04 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. MICHAEL G MANSKE (PRESIDENT) |
| Authorized Official Telephone | 2626874479 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207P00000X | Emergency Medicine | Allopathic & Osteopathic Physicians |
| Street Address |
3801 SPRING ST |
| City | RACINE |
| State | WI |
| Zip Code | 53405-1667 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033115787 | Mark A. Pelton | Pharmacist | 3801 Spring St, Racine, WI 53405-1667 | 2005-06-27 |
| 1528685252 | Tanya Higgins | Nurse Anesthetist, Certified Registered | 3801 Spring St, Racine, WI 53405 | 2020-06-29 |
| 1033583190 | Jennifer Scidmore | Physician Assistant | 3801 Spring St, Racine, WI 53405 | 2015-11-30 |
| 1265774715 | Erin Cecelia Siegel | Internal Medicine | 3801 Spring St, Racine, WI 53405 | 2013-03-22 |
| 1578866448 | Courtney Brooke Hoffman | Nurse Anesthetist, Certified Registered | 3801 Spring St, Racine, WI 53405-1667 | 2010-12-14 |
| 1740595032 | Renate A Villarreal | Physician Assistant | 3801 Spring St, Racine, WI 53405-1667 | 2010-08-11 |
| 1669784112 | Peter David Blochowicz | Nurse Anesthetist, Certified Registered | 3801 Spring St, Racine, WI 53405-1667 | 2010-07-12 |
| 1154651115 | Jeffrey Thomas Vaughan Kroeger | Nurse Anesthetist, Certified Registered | 3801 Spring St, Racine, WI 53405-1667 | 2010-01-13 |
| 1467782748 | Racine Anesthesia Services, LLC | Nurse Anesthetist, Certified Registered | 3801 Spring St, Racine, WI 53405-1667 | 2010-01-08 |
| 1104058528 | Matthew T Czerniak | Physician Assistant | 3801 Spring St, Racine, WI 53405-1667 | 2009-08-18 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609407923 | Anita Kathy Nykaza | Dietitian, Registered | 3805 A Suite 311, Racine, WI 53405 | 2020-01-27 |
| 1023666062 | Shawn L Drulia | Physician Assistant | 3805 Spring St #320, Racine, WI 53405 | 2019-09-03 |
| 1235627720 | Oxygen One, Inc. | Durable Medical Equipment & Medical Supplies | 3805a Spring Street, Suite 210, Racine, WI 53405 | 2018-04-30 |
| 1356838650 | Melissa Metzger | Psychologist | 2340 Mohr Ave, Racine, WI 53405 | 2018-04-23 |
| 1689029217 | Melissa Ileen Swainston | Nurse Practitioner | 3803 Spring St., Suite Number 410, Racine, WI 53405 | 2016-05-02 |
| 1215305487 | Denetta Lauraelaine Flowers | Licensed Practical Nurse | 4311 Durand Ave., #104, Mt.pleasant, WI 53405 | 2015-09-04 |
| 1841675204 | Colleen Koderca | Registered Nurse | 3317-meachem Rd, Racine, WI 53405 | 2015-07-28 |
| 1790102986 | Georges Wakim | Specialist/Technologist | 3811 Spring St., Suite 102, Racine, WI 53405 | 2014-03-25 |
| 1982021176 | Matthew F Patzke | Specialist/Technologist | 3811 Spring Street Suite 102, Racine, WI 53405 | 2014-03-25 |
| 1073930269 | Jessica Geisler | Specialist/Technologist | 3811 Spring Street Suite #102, Racine, WI 53405 | 2014-03-25 |
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| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073824207 | Andrew Thomas Konicek | Emergency Medicine | 3801 Spring Street, Racine, WI 53403-1010 | 2010-06-22 |
| 1043530025 | Michael Vincent Kowal | Emergency Medicine | 3801 Spring Street, Racine, WI 53405 | 2010-06-01 |
| 1730353517 | Brian Michael Ames | Emergency Medicine | 3805b Spring St, Ste 230, Racine, WI 53405-1643 | 2008-04-14 |
| 1942347737 | Antoinette Marie Zell | Emergency Medicine | 2405 Northwestern Ave, Suite #115, Racine, WI 53404-2503 | 2007-01-31 |
| 1477544427 | Jeffrey M Vanbendegom | Emergency Medicine | 3801 Spring St, Racine, WI 53405-1667 | 2005-10-31 |
| 1427048552 | Ruthann M Cunningham | Emergency Medicine | 3801 Spring St, Racine, WI 53405-1667 | 2005-10-28 |
| 1699764068 | Emmie Andrea Chen | Emergency Medicine | 3805b Spring St, Suite 230, Racine, WI 53405-1641 | 2005-10-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275012171 | Kathleen Ray Price | Emergency Medicine | 146 Old Orchard Ln, Neenah, WI 54956-4954 | 2018-08-10 |
| 1043730690 | Jonathan Weseman | Emergency Medicine | 3003 University Dr, Marinette, Marinette, WI 54143 | 2017-06-25 |
| 1780115634 | Sean Anthony Mackman | Emergency Medicine | 9200 W Wisconsin Ave # 1p, Milwaukee, WI 53226-3522 | 2017-03-22 |
| 1114375367 | Arthur How Jen Chiu | Emergency Medicine | 1726 Chadbourne Ave, Madison, WI 53726-4108 | 2016-05-28 |
| 1912352873 | Glenn Thiel | Emergency Medicine | N20015 Echo Lake Rd, Niagra, WI 54151 | 2016-04-28 |
| 1437512613 | Jacob Tyler Clark | Emergency Medicine | 1035 Kepler Dr, Green Bay, WI 54311-8320 | 2016-04-04 |
| 1639532526 | Rinal Patel | Emergency Medicine | 9200 W Loomis Rd Ste 212, Franklin, WI 53132 | 2016-03-30 |
| 1871955187 | Scott Erickson | Emergency Medicine | 4876 N Sheffield Ave, Whitefish Bay, WI 53217-5962 | 2016-03-25 |
| 1992166821 | Nicholas W Hawley | Emergency Medicine | 3003 W Good Hope Rd # Bcm320, Milwaukee, WI 53209-2042 | 2016-03-20 |
| 1164802138 | Adam Nicholson | Emergency Medicine | 600 Highlanc Ave, Madison, WI 53792-0001 | 2015-06-04 |
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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.