DR. JOHN CHARLES PICK-JACOBS (NPI# 1255607057) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255607057 |
| Entity Type | Individual |
| Full Name | DR. JOHN CHARLES PICK-JACOBS |
| Credential | D.O. |
| Practice Address |
7401 104th Ave Ste 110 Kenosha WI 53142 |
| Mailing Address |
7401 104th Ave Ste 110 Kenosha WI 53142-7845 |
| Practice Telephone | 2627645595 |
| Mailing Telephone | 2627645595 |
| Mailing Fax Number | 2627649314 |
| Enumeration Date | 2012-03-26 |
| Last Update Date | 2018-09-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207QS0010X |
Family Medicine Specialization: Sports Medicine |
61756-21 | WI | Allopathic & Osteopathic Physicians |
| Street Address |
7401 104TH AVE STE 110 |
| City | KENOSHA |
| State | WI |
| Zip Code | 53142 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942526330 | Benjamin Joseph Lasee | Orthopaedic Surgery | 7401 104th Ave Ste 110, Kenosha, WI 53142-7845 | 2010-04-11 |
| 1518509413 | Jennifer E Armstrong | Nurse Practitioner | 7401 104th Ave Ste 110, Kenosha, WI 53142-7845 | 2019-10-11 |
| 1447774435 | Natalie Nicole Coorlas | Nurse Practitioner | 7401 104th Ave Ste 110, Kenosha, WI 53142-7845 | 2017-08-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588297816 | Caring Hearts Home Health Care | In Home Supportive Care | 6021-57th Ave, Suite C103, Kenosha, WI 53142 | 2020-02-14 |
| 1144785395 | Michael L Wrzesinski | Counselor | 4109 67th Street, Kenosha, WI 53142 | 2019-02-01 |
| 1720538499 | David Smith | Counselor | 10900 67th Street, Kenosha, WI 53142 | 2016-10-06 |
| 1326404641 | Smile Doctors Ltd | Dentist | 7003 39th Ave, Kenosha, WI 53142 | 2016-01-04 |
| 1225409485 | Antonia Marie Decker | Physician Assistant | 10400 75th St. Ste 204, Kenosha, WI 53142 | 2015-10-14 |
| 1780060582 | Joshua Haas | Pharmacist | 7701 Green Bay Road, Kenosha, IL 53142 | 2015-08-04 |
| 1811379225 | Dana Mary Stout | Registered Nurse | 7401 104th Avenue, Suite 110, Comprehensive Orthopaedics, S.c., Kenosha, WI 53142 | 2015-06-22 |
| 1669815569 | Joshua Knute Elson | Radiology | 6811 118th Ave, Kenosha, WI 53142 | 2013-04-10 |
| 1356610166 | Michael J Gallo | Pharmacist | 7535 North Greenbay Rd, Kenosha, WI 53142 | 2011-12-22 |
| 1720357999 | Orest Carnevale | Registered Nurse | 7316 155th Ct, Kenosha, WI 53142 | 2011-12-18 |
| Find all providers in zip 53142 | ||||
| Taxonomy Code | 207QS0010X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Specialization | Sports Medicine |
| A family medicine physician that is trained to be responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention of injury and illness. A sports medicine physician must have knowledge and experience in the promotion of wellness and the prevention of injury. Knowledge about special areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation, injuries (treatment and prevention and referral practice) and the role of exercise in promoting a healthy lifestyle are essential to the practice of sports medicine. The sports medicine physician requires special education to provide the knowledge to improve the health care of the individual engaged in physical exercise (sports) whether as an individual or in team participation. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Family Medicine, 2007. http://www.theabfm.org/. American Osteopathic Board of Family Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295717445 | Comprehensive Orthopaedics Sc | Family Medicine | 7401 104th Ave, Suite 110, Kenosha, WI 53142-7845 | 2005-11-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811203706 | Matthew M Brown | Family Medicine | 1705 Hoffman St, Madison, WI 53704-2510 | 2010-08-30 |
| 1174764906 | Mark W Niedfeldt, Md, LLC | Family Medicine | 10556 N Port Washington Rd, Ste 101, Mequon, WI 53092-5586 | 2009-03-06 |
| 1225151558 | Patrick Earl Mcdonough | Family Medicine | 235 State Street, St. Croix Falls, WI 54024 | 2007-04-10 |
| 1790858462 | Shanyn Colleen Lancaster | Family Medicine | 1250 W Wisconsin Ave, Student Health, Schroeder Complex, Lower Level, Milwaukee, WI 53233-2225 | 2006-11-17 |
| 1306919907 | Steven Alan Giles | Family Medicine | 3316 Ridgeline Dr, Waukesha, WI 53188 | 2006-11-15 |
| 1689220527 | Delo Sport and Stem Sc | Family Medicine | 2595 Development Dr Ste 140, Green Bay, WI 54311-4267 | 2019-08-15 |
| 1417377755 | Todd Domeyer | Family Medicine | 3113 Saemann Ave, Sheboygan, WI 53081 | 2014-04-25 |
| 1972949501 | Chad Joseph Giles | Family Medicine | 4100 State Highway 66, Stevens Point, WI 54482 | 2013-05-22 |
| 1073956363 | Lucianne Helena Olewinski | Family Medicine | Uw Hospital and Clinics, 600 Highland Ave, Madison, WI 53792-0001 | 2013-04-17 |
| 1902166978 | Jessica L Juntunen | Family Medicine | 5200 Hummingbird Rd, Suite 100, Wausau, WI 54401-6312 | 2012-05-23 |
| 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.