ST GEORGE CLINICS, LLC (NPI# 1194216416) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194216416 |
| Entity Type | Organization |
| Organization Name | ST GEORGE CLINICS, LLC |
| Practice Address |
308 E Main St Waterford WI 53185-4306 |
| Practice Telephone | 2629233777 |
| Mailing Telephone | 2629233777 |
| Enumeration Date | 2018-05-22 |
| Last Update Date | 2018-05-22 |
| Authorized Official Name | MRS. TATJANA STEVANOVIC (ADULT NURSE PRACTIONER) |
| Authorized Official Telephone | 2629233777 |
| Authorized Official Credential | NP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QM1300X |
Clinic/Center Specialization: Multi-Specialty |
Ambulatory Health Care Facilities | ||
| Y | 261QM1300X |
Clinic/Center Specialization: Multi-Specialty |
52D1037628 | WI | Ambulatory Health Care Facilities |
| Street Address |
308 E MAIN ST |
| City | WATERFORD |
| State | WI |
| Zip Code | 53185-4306 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649755695 | Alyssa Jane Revolinski | Respite Care | 269435 S Elm Lane, Waterford, WI 53185 | 2018-09-26 |
| 1871973370 | Julie Minikowski | Community Health Worker | 207 Milwaukee Avenue, A, Waterford, WI 53185 | 2015-06-01 |
| 1629235031 | Fluegge Optical | Technician/Technologist | 920 E Main Street, Waterford, WI 53185 | 2008-05-22 |
| 1659598209 | Julie Michals | Occupational Therapist | 1701 Sharp Road, Waterford, WI 53185 | 2007-04-18 |
| 1518072768 | Jennifer Jayne Decker | Family Medicine | 818 Forrest Ln, Waterford, WI 53185 | 2006-08-20 |
| 1215966908 | Amy Beth Flock | Physical Therapy Assistant | 2319 Fox Knoll Dr, Waterford, WI 53185 | 2006-07-03 |
| 1750762472 | Tesalia R Renteria | Family Medicine | 818 Forest Ln, Waterford, WI 53185 | 2015-06-18 |
| 1649651092 | Kathryn C Halyko | Pediatrics | 818 Forest Ln, Waterford, WI 53185 | 2015-06-11 |
| 1518109735 | Daniel A Allison | Family Medicine | 818 Forest Ln, Waterford, WI 53185 | 2009-04-02 |
| 1811178478 | Daniel Mark Gifford | Speech-Language Pathologist | 1701 Sharp Rd, Lakeview Specialty Hospital, Waterford, WI 53185 | 2007-11-23 |
| Find all providers in zip 53185 | ||||
| Taxonomy Code | 261QM1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Multi-Specialty |
| Definition to come... |
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| 1881182889 | Allure Medical of Wisconsin Pllc | Clinic/Center | 1930 W Bluemound Rd Ste 340, Waukesha, WI 53186 | 2018-04-25 |
| 1811412091 | H2o:health Hydration Oasis | Clinic/Center | 17110 W Greenfield Ave Ste 6, Brookfield, WI 53005-6899 | 2017-08-08 |
| 1003336884 | 3d Brows and Wellness LLC | Clinic/Center | 801 Hoffman Rd Ste 106, Green Bay, WI 54301-1462 | 2017-06-22 |
| 1437529120 | Quad/med, LLC | Clinic/Center | W227 N6103 Sussex Rd, Sussex, WI 53089 | 2015-10-07 |
| 1891106092 | Wisconsin Wellness Clinic | Clinic/Center | 280 Regency Ct, Suite 100, Brookfield, WI 53045-6165 | 2014-05-11 |
| 1437317708 | Ascension Medical Group-fox Valley Wisconsin, Inc | Clinic/Center | 1160 Service Rd, Kiel, WI 53042 | 2008-05-23 |
| 1679731954 | Ascension Medical Group-fox Valley Wisconsin, Inc | Clinic/Center | 1128 E Parkway Ave, Oshkosh, WI 54901 | 2008-05-23 |
| 1669639142 | Ascension Medical Group-fox Valley Wisconsin, Inc | Clinic/Center | N9642 County Rd N, Appleton, WI 54915 | 2008-05-21 |
| Find all providers with the same taxonomy | ||||
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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.