DR. SAM HOFMAN (NPI# 1245496801) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245496801 |
| Entity Type | Individual |
| Full Name | DR. SAM HOFMAN |
| Credential | M.D. |
| Practice Address |
1715 Dousman St Green Bay WI 54303-3211 |
| Practice Telephone | 9204964780 |
| Mailing Telephone | 9204964700 |
| Enumeration Date | 2008-08-04 |
| Last Update Date | 2019-08-29 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | 53873 | WI | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
1715 DOUSMAN ST |
| City | GREEN BAY |
| State | WI |
| Zip Code | 54303-3211 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629071485 | Gayle M Kasdorf | Internal Medicine | 1715 Dousman St, Green Bay, WI 54303-3211 | 2005-05-24 |
| 1508476771 | Alea Meyer | Audiologist | 1715 Dousman St, Green Bay, WI 54303-3211 | 2020-08-03 |
| 1003476276 | Jenna Mae Hanson | Physician Assistant | 1715 Dousman St, Green Bay, WI 54303-3211 | 2019-06-19 |
| 1932672409 | Kaylee Elizabeth Hoppe | Physician Assistant | 1715 Dousman St, Green Bay, WI 54303-3211 | 2019-01-08 |
| 1205307170 | Marjorie Hatszegi | Nurse Practitioner | 1715 Dousman St, Green Bay, WI 54303-3211 | 2018-12-17 |
| 1700362860 | Cassandra Jean Bedore | Audiologist | 1715 Dousman St, Green Bay, WI 54303-3211 | 2018-07-12 |
| 1033632336 | Shilpa Mohan Ullikashi | Pediatrics | 1715 Dousman St, Green Bay, WI 54303-3211 | 2017-07-19 |
| 1811431372 | Lauryn Carlson | Registered Nurse | 1715 Dousman St, Green Bay, WI 54303-3211 | 2016-12-16 |
| 1831543529 | Rachael John | Occupational Therapist | 1715 Dousman St, Green Bay, WI 54303-3211 | 2016-04-19 |
| 1780099911 | Anusha Surender | Internal Medicine | 1715 Dousman St, Green Bay, WI 54303-3211 | 2014-06-26 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952921033 | Ashley Marie Vandermoss | Social Worker | 1601 W Mason Street, Green Bay, WI 54303 | 2020-04-20 |
| 1598307423 | Jean Marie Castaneda | Case Manager/Care Coordinator | 2517 N. Court, Green Bay, WI 54303 | 2019-10-11 |
| 1215579552 | Integrated Treatment Centers, LLC | Clinic/Center | 2311 W Mason Street, Green Bay, WI 54303 | 2019-10-08 |
| 1003460551 | Affordable Dentures & Implants - Green Bay, S.c. | Dentist | 1800-c W. Mason Street, Green Bay, WI 54303 | 2019-08-01 |
| 1164940375 | Kaeley Rae Blaney | Student in an Organized Health Care Education/Training Program | 2088 Memorial Drive #208, Green Bay, WI 54303 | 2017-09-07 |
| 1518498047 | Treatment Providers LLC | Clinic/Center | 2731 N Packerland Dr Ste A, Green Bay, WI 54303 | 2017-03-26 |
| 1851840565 | Back To Balance Chiropractic, LLC | Chiropractor | 110 Packerland Drive, Suite B, Green Bay, WI 54303 | 2016-09-23 |
| 1710361001 | Matthew Lemay | Acupuncturist | 727 E Walnut, Suite B2, Green Bay, WI 54303 | 2015-07-16 |
| 1144600149 | Carrie Jean Banaszak | Counselor | 1039 Mason Street, Green Bay, WI 54303 | 2015-06-04 |
| 1174921993 | Kensey Meyer | Occupational Therapy Assistant | 1555 Dousman Road, Seymour, WI 54303 | 2014-12-10 |
| Find all providers in zip 54303 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| 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 Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407830011 | Scott G Zahn | Pediatrics | 2253 W Mason St, Suite 200, Green Bay, WI 54303-4706 | 2005-12-06 |
| 1033632336 | Shilpa Mohan Ullikashi | Pediatrics | 1715 Dousman St, Green Bay, WI 54303-3211 | 2017-07-19 |
| 1831514900 | Pradeep Bangalore Prakash | Pediatrics | 835 S Van Buren St, Green Bay, WI 54301-3526 | 2014-02-26 |
| 1386983930 | Children's Hospital of Wisconsin | Pediatrics | 503 S Monroe Ave, Green Bay, WI 54301-4017 | 2013-02-01 |
| 1760741136 | Ashley Michelle Flannery | Pediatrics | 1630 Commanche Ave, Green Bay, WI 54313-5753 | 2012-05-04 |
| 1477843001 | Brandon Michael Rucker | Pediatrics | 1160 Kepler Dr, Green Bay, WI 54311-8321 | 2011-04-16 |
| 1629208483 | Anju Bradford | Pediatrics | 2253 W Mason St, Green Bay, WI 54303 | 2009-07-15 |
| 1154563229 | Joshua D Rankin | Pediatrics | 2793 Lineville Rd, Green Bay, WI 54313-7152 | 2009-04-03 |
| 1396997565 | Megan Harrison Linn | Pediatrics | 835 S Van Buren St, Green Bay, WI 54301-3526 | 2008-10-18 |
| 1336300276 | Bradley Allen Locke | Pediatrics | 2793 Lineville Rd, Green Bay, WI 54313-7152 | 2008-06-23 |
| Find all providers in GREEN BAY | ||||
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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.