ROGER AXTELL (NPI# 1215958178) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215958178 |
| Entity Type | Individual |
| Full Name | ROGER AXTELL |
| Credential | M.D. |
| Practice Address |
2875 S 171st St New Berlin WI 53151-3511 |
| Practice Telephone | 2627863107 |
| Practice Fax Number | 2627800442 |
| Mailing Telephone | 2627863107 |
| Mailing Fax Number | 2627800442 |
| Enumeration Date | 2006-07-23 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
37946 | WI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 33330500 | 05 |
| Street Address |
2875 S 171ST ST |
| City | NEW BERLIN |
| State | WI |
| Zip Code | 53151-3511 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225072721 | Mack Karnes | Radiology | 2875 S 171st St, New Berlin, WI 53151-3511 | 2006-06-15 |
| 1427293182 | Aurora Medical Group, Inc. | Radiology | 2875 S 171st St, New Berlin, WI 53151-3511 | 2008-12-10 |
| 1730202987 | Joseph Schmidt | Radiology | 2875 S 171st St, New Berlin, WI 53151-3511 | 2007-04-10 |
| 1982798450 | Scott Matthew Reabe | Radiology | 2875 S 171st St, New Berlin, WI 53151-3511 | 2006-10-02 |
| 1487755476 | Werner Kordas | Radiology | 2875 S 171st St, New Berlin, WI 53151-3511 | 2006-09-25 |
| 1174532626 | Jeffery Scherer | Radiology | 2875 S 171st St, New Berlin, WI 53151-3511 | 2006-08-05 |
| 1255345823 | Joseph Rhett Whitnah | Radiology | 2875 S 171st St, New Berlin, WI 53151-3511 | 2006-07-28 |
| 1144234766 | Thomas Calvy | Radiology | 2875 S 171st St, New Berlin, WI 53151-3511 | 2006-07-28 |
| 1104840636 | Nancy Blankenship | Radiology | 2875 S 171st St, New Berlin, WI 53151-3511 | 2006-07-27 |
| 1154345072 | Keith Bernard | Radiology | 2875 S 171st St, New Berlin, WI 53151-3511 | 2006-07-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629527486 | Natural Look Salon and Wigs LLC | Durable Medical Equipment & Medical Supplies | 4805 S. Moorland Rd, New Berlin, WI 53151 | 2016-09-22 |
| 1396193033 | New Berlin Medical Services, LLC | Clinic/Center | 15324 W Beloit Road, New Berlin, WI 53151 | 2016-06-02 |
| 1063899680 | Costco Wholesale Corporation | Eyewear Supplier (Equipment, not the service) | 15300 West Grange Avenue, New Berlin, WI 53151 | 2015-05-04 |
| 1871970368 | Mary Spath | Physical Therapy Assistant | 2810 South Acredale Road, New Berlin, WI 53151 | 2015-05-04 |
| 1669885471 | Wauwatosa Prescription Center, Inc. | Pharmacy | 4855 S Moorland Road, New Berlin, WI 53151 | 2014-06-09 |
| 1750711446 | Pure Family Chiropractic LLC | Chiropractor | 3504 S. Moorland Road, New Berlin, WI 53151 | 2013-11-18 |
| 1336578202 | Hamilton John Dowden | Chiropractor | 3504 S Moorland Rd, New Berlin, WI 53151 | 2013-11-01 |
| 1053653618 | Danielle Lynn Lucio | Acupuncturist | 15807 W. National Ave., New Berlin, WI 53151 | 2013-03-21 |
| 1306195110 | Marlena J Friedrich | Registered Nurse | 1709 S. 171st Street, New Berlin, WI 53151 | 2012-09-07 |
| 1548519176 | Patricia M Friedrich | Licensed Practical Nurse | 1709 So. 171st Street, New Berlin, WI 53151 | 2012-08-29 |
| Find all providers in zip 53151 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| 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 Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285781773 | Douglas Robert Conners | Radiology | 1910 S Parkwood Ln, New Berlin, WI 53151-2456 | 2007-01-05 |
| 1225072721 | Mack Karnes | Radiology | 2875 S 171st St, New Berlin, WI 53151-3511 | 2006-06-15 |
| 1427293182 | Aurora Medical Group, Inc. | Radiology | 2875 S 171st St, New Berlin, WI 53151-3511 | 2008-12-10 |
| 1730202987 | Joseph Schmidt | Radiology | 2875 S 171st St, New Berlin, WI 53151-3511 | 2007-04-10 |
| 1982798450 | Scott Matthew Reabe | Radiology | 2875 S 171st St, New Berlin, WI 53151-3511 | 2006-10-02 |
| 1487755476 | Werner Kordas | Radiology | 2875 S 171st St, New Berlin, WI 53151-3511 | 2006-09-25 |
| 1174532626 | Jeffery Scherer | Radiology | 2875 S 171st St, New Berlin, WI 53151-3511 | 2006-08-05 |
| 1255345823 | Joseph Rhett Whitnah | Radiology | 2875 S 171st St, New Berlin, WI 53151-3511 | 2006-07-28 |
| 1144234766 | Thomas Calvy | Radiology | 2875 S 171st St, New Berlin, WI 53151-3511 | 2006-07-28 |
| 1104840636 | Nancy Blankenship | Radiology | 2875 S 171st St, New Berlin, WI 53151-3511 | 2006-07-27 |
| Find all providers in NEW BERLIN | ||||
| City | NEW BERLIN |
| Zip Code | 53151 |
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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.