COMMUNITY PEDIATRICS SC (NPI# 1275749566) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275749566 |
| Entity Type | Organization |
| Organization Name | COMMUNITY PEDIATRICS SC |
| Practice Address |
109 Warren St Ste 4 Beaver Dam WI 53916-3082 |
| Practice Telephone | 9208853305 |
| Practice Fax Number | 9208855506 |
| Mailing Telephone | 9208853305 |
| Mailing Fax Number | 9208855506 |
| Enumeration Date | 2007-05-15 |
| Last Update Date | 2010-04-08 |
| Authorized Official Name | MS. DOROTHY JEAN LARSON (ACCOUNT MANAGER) |
| Authorized Official Telephone | 9208853305 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 34638800 | 05 |
| Street Address |
109 WARREN ST STE 4 |
| City | BEAVER DAM |
| State | WI |
| Zip Code | 53916-3082 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881103893 | Brittany N Vanden Heuvel | Nurse Practitioner | 109 Warren St Ste 4, Beaver Dam, WI 53916-3082 | 2017-09-21 |
| 1063878643 | Laura M Pierre | Nurse Practitioner | 109 Warren St Ste 4, Beaver Dam, WI 53916-3082 | 2016-01-12 |
| 1710272778 | Kaitlyn N Pufahl | Clinical Nurse Specialist | 109 Warren St Ste 4, Beaver Dam, WI 53916-3082 | 2011-06-17 |
| 1972755783 | Laura Jane Lerwick | Nurse Practitioner | 109 Warren St Ste 4, Beaver Dam, WI 53916-3082 | 2008-10-13 |
| 1437354602 | Jay M Miesfeld | Pediatrics | 109 Warren St Ste 4, Beaver Dam, WI 53916-3082 | 2007-06-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538718283 | Paulette Neibauer | Technician | N7262 Farwell Rd., Beaver Dam, WI 53916 | 2019-09-05 |
| 1902336597 | Tricounty Homecare Inc | In Home Supportive Care | 140 Corporate Dr Ste 2, Beaver Dam, WI 53916 | 2017-06-15 |
| 1528502754 | Jessica Marie Blatz | Counselor | 809 Park Aveune, Beaver Dam, WI 53916 | 2016-12-07 |
| 1376090886 | Beaver Dam Hearing Care, LLC | Hearing Aid Equipment | 705 University Ave, Suite 170, Beaver Dam, WI 53916 | 2016-09-01 |
| 1275902546 | Beaver Dam Community Hospitals Inc | Pharmacy | 705 S University Ave Ste 180, Beaver Dam, WI 53916 | 2015-09-17 |
| 1609242825 | Tami Joe Delisle | Counselor | 207 North Spring Street, Beaver Dam, WI 53916 | 2015-08-12 |
| 1366833394 | Beaver Dam Community Hospitals, Inc | Surgery | 705 S University Ave Ste 350, Beaver Dam, WI 53916 | 2015-02-12 |
| 1326471608 | Raquel Rodriguez-guzman | Pharmacist | 205 La Crosse Street, Beaver Dam, WI 53916 | 2013-08-09 |
| 1558608828 | Mary Y Kunz | Licensed Practical Nurse | 6550 N Highway 151 Lot 63, Beaverdam, WI 53916 | 2013-01-07 |
| 1881938454 | Brock Holden Slinger | Physical Therapist | 205 Monroe St. #13, Beaver Dam, WI 53916 | 2012-11-20 |
| Find all providers in zip 53916 | ||||
| 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 |
|---|---|---|---|---|
| 1417958026 | Elizabeth Michael Peterson | Pediatrics | 109 Warren St, Suite 4, Beaver Dam, WI 53916-3082 | 2005-08-04 |
| 1174841076 | Jessica L Miesfeld | Pediatrics | 109 Warren St, Ste 4, Beaver Dam, WI 53916-3082 | 2010-05-17 |
| 1437354602 | Jay M Miesfeld | Pediatrics | 109 Warren St Ste 4, Beaver Dam, WI 53916-3082 | 2007-06-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437767977 | St Francs Pediatrics | Pediatrics | 3201 S 16th St Ste 100, Milwaukee, WI 53215-4579 | 2020-07-21 |
| 1780155275 | Children's Health System, Inc. | Pediatrics | 6809 122nd Avenue, Kenosha, WI 54342-7335 | 2018-12-10 |
| 1467972950 | Cameron Trammell Shamsi Kasmai | Pediatrics | 9000 W Wisconsin Ave # Ms 681, Milwaukee, WI 53226-4874 | 2017-06-26 |
| 1669903993 | Kristin Zorn | Pediatrics | 8701 W Watertown Plank Rd # Mfrc3018, Milwaukee, WI 53226-3548 | 2017-03-27 |
| 1487195822 | Jane A Rivas | Pediatrics | 9000 W Wisconsin Ave # C550, Milwaukee, WI 53226-4874 | 2017-03-18 |
| 1467996991 | Children's Medical Group | Pediatrics | N168w22730 Prairie View Lane, Jackson, WI 53037 | 2016-12-19 |
| 1366997496 | Ujuchukwu Chizurum Okpechi | Pediatrics | 2700 W 9th Ave Ste 211, Oshkosh, WI 54904-7865 | 2016-08-18 |
| 1396193454 | Helen Gerseny Waterman | Pediatrics | 123 E Mifflin St Apt 200, Madison, WI 53703-2810 | 2016-05-31 |
| 1972951127 | Hillary Herman | Pediatrics | 1506 S Oneida St Fl 5, Appleton, WI 54915-1305 | 2016-05-27 |
| 1811350416 | Brittney Allison Krueger | Pediatrics | 4855 S Moorland Rd Ste 150, New Berlin, WI 53151-7495 | 2016-03-31 |
| Find all providers with the same taxonomy | ||||
| City | BEAVER DAM |
| Zip Code | 53916 |
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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.