JELENA KRAVIC SHADICK (NPI# 1316331960) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316331960 |
| Entity Type | Individual |
| Full Name | JELENA KRAVIC SHADICK |
| Other Name | DR. JELENA KRAVIC |
| Credential | M.D. |
| Practice Address |
2700 W 9th Ave Oshkosh WI 54904 |
| Mailing Address |
2700 W 9th Ave Oshkosh WI 54904-7247 |
| Practice Telephone | 9046334199 |
| Enumeration Date | 2015-03-21 |
| Last Update Date | 2018-06-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | 68579 | WI | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
2700 W 9TH AVE |
| City | OSHKOSH |
| State | WI |
| Zip Code | 54904 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598762841 | Nathan C Meloy | Anesthesiology | 2700 W 9th Ave, Suite 205, Oshkosh, WI 54904-7247 | 2005-07-01 |
| 1629547633 | Tosha Wright | Nurse Practitioner | 2700 W 9th Ave, Oshkosh, WI 54904-7247 | 2018-11-19 |
| 1265897821 | Nicole M Edwards | Specialist/Technologist | 2700 W 9th Ave, Suite 125, Oshkosh, WI 54904-7247 | 2015-12-28 |
| 1811390180 | Kelyn O'brien | Nurse Practitioner | 2700 W 9th Ave, Oshkosh, WI 54904-7247 | 2014-10-01 |
| 1700286192 | Jill Kahler | Clinical Exercise Physiologist | 2700 W 9th Ave, Suite 107, Oshkosh, WI 54904-7247 | 2014-09-04 |
| 1578963096 | Gretta C. Grube | Nurse Practitioner | 2700 W 9th Ave, Oshkosh, WI 54904-7247 | 2014-09-03 |
| 1225448681 | Kelly E O'connor | Advanced Practice Midwife | 2700 W 9th Ave, Ste 230, Oshkosh, WI 54904-7247 | 2014-05-06 |
| 1992070650 | Julia E Salomon | Dietitian, Registered | 2700 W 9th Ave, Oshkosh, WI 54904-7247 | 2012-03-14 |
| 1598039943 | Scott Michael Pethan | Clinical Exercise Physiologist | 2700 W 9th Ave, Suite 107, Oshkosh, WI 54904-7247 | 2012-03-02 |
| 1023386950 | Tracy Ann Herrewig | Clinical Exercise Physiologist | 2700 W 9th Ave, Suite 107, Oshkosh, WI 54904-7247 | 2011-12-07 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326567140 | Mary Kay Benotsch | Registered Nurse | 505 South Washburn Street, Oshkosh, WI 54904 | 2017-09-13 |
| 1295278356 | Braden Williams | Nurse Anesthetist, Certified Registered | 955 Pheasant Creek Dr, Oshkosh, WI 54904 | 2016-11-22 |
| 1740651330 | Ams of Wisconsin - Oshkosh | Clinic/Center | 595 South Washburn St, Oshkosh, WI 54904 | 2015-10-08 |
| 1174990253 | Kaochi Desjheannette Vang | Occupational Therapist | Aurora Medical Center of Oshkosh - Rehab, 855 N. Westhaven Drive, Oshkosh, WI 54904 | 2015-08-25 |
| 1326453200 | Chey V Collura | Surgery | 2700 W 9th Ave Ste 310, Oshkosh, WI 54904 | 2014-06-30 |
| 1275847543 | Eden Rehabilitation Suites and Green House Homes, Inc. | Skilled Nursing Facility | 3151 Eden Court, Oshkosh, WI 54904 | 2010-07-29 |
| 1700043502 | Eric Koehler | Physical Therapist | 3475 Omro Rd Ste 300, Oshkosh, WI 54904 | 2008-05-20 |
| 1831396167 | Angela Marie Wade | Behavioral Analyst | 2986 Fitchburg Ct., Oshkosh, WI 54904 | 2007-06-29 |
| 1174642383 | Michael Gerard Bell | Dentist | 1795 West Pointe Dr, Oshkosh, WI 54904 | 2007-03-28 |
| 1235253030 | Jessica Anne Bielmeier | Registered Nurse | 2700 West 9th Ave #125, Oshkosh, WI 54904 | 2007-03-19 |
| Find all providers in zip 54904 | ||||
| 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 |
|---|---|---|---|---|
| 1366997496 | Ujuchukwu Chizurum Okpechi | Pediatrics | 2700 W 9th Ave Ste 211, Oshkosh, WI 54904-7865 | 2016-08-18 |
| 1962496869 | Laurie L Muller | Pediatrics | 964 Trillium Trl, Oshkosh, WI 54904-7670 | 2005-09-07 |
| 1003109794 | Zainab Kagen | Pediatrics | 2700 W 9th Ave, Suite 211, Oshkosh, WI 54904-7247 | 2011-05-27 |
| 1093032104 | Angela Katsma | Pediatrics | 1855 S Koeller St, Oshkosh, WI 54902-6214 | 2010-04-28 |
| 1578748802 | Santi Budiasih | Pediatrics | 1855 S Koeller St, Oshkosh, WI 54902-6214 | 2008-01-06 |
| 1942319637 | Valerie Zapolsky | Pediatrics | 855 N Westhaven Dr, Oshkosh, WI 54904 | 2006-08-29 |
| 1376651596 | Matthew Paige Downs | Pediatrics | 855 N Westhaven Dr, Oshkosh, WI 54904 | 2006-08-28 |
| 1215045836 | Scott B Johnson | Pediatrics | 855 N Westhaven Dr, Oshkosh, WI 54904 | 2006-08-25 |
| 1306953419 | Jean Ruth Thur | Pediatrics | 855 N Westhaven Dr, Oshkosh, WI 54904 | 2006-08-24 |
| 1336256882 | Vee Ly | Pediatrics | 855 N Westhaven Dr, Oshkosh, WI 54904 | 2006-08-23 |
| Find all providers in OSHKOSH | ||||
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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.