LAURA P VAN ROO (NPI# 1316996622) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316996622 |
| Entity Type | Individual |
| Full Name | LAURA P VAN ROO |
| Credential | PA-C |
| Practice Address |
2817 New Pinery Rd Portage WI 53901-9240 |
| Mailing Address |
7974 Uw Health Ct Middleton WI 53562-5531 |
| Practice Telephone | 6087424131 |
| Practice Fax Number | 6087455098 |
| Mailing Telephone | 6088295201 |
| Mailing Fax Number | 6088330999 |
| Enumeration Date | 2006-05-06 |
| Last Update Date | 2019-05-21 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363A00000X | Physician Assistant | 1355-023 | WI | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
1355-023 | WI | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
1355-023 | WI | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | DEAN HEALTH INSURANCE | 60073 | 01 |
| WI | 41961500 | 05 |
| Street Address |
2817 NEW PINERY RD |
| City | PORTAGE |
| State | WI |
| Zip Code | 53901-9240 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174506307 | James T Gariti Sr. | Emergency Medicine | 2817 New Pinery Rd, Divine Savior Healthcare Inc, Portage, WI 53901-9257 | 2005-11-22 |
| 1881208635 | Sophie M Tessner | Pharmacist | 2817 New Pinery Rd, Portage, WI 53901-9240 | 2020-08-31 |
| 1164047015 | Stephanie Jo Holt | Nurse Practitioner | 2817 New Pinery Rd, Portage, WI 53901-9240 | 2020-06-16 |
| 1770132268 | Anna Carole Hormig | Registered Nurse | 2817 New Pinery Rd, Portage, WI 53901-9240 | 2019-09-06 |
| 1790338655 | Andrea Olsen | Occupational Therapist | 2817 New Pinery Rd, Portage, WI 53901-9240 | 2019-07-19 |
| 1316590417 | Nicole Rae Sletten | Occupational Therapy Assistant | 2817 New Pinery Rd, Portage, WI 53901-9240 | 2019-07-18 |
| 1851944078 | Andrew Larson | Physical Therapist | 2817 New Pinery Rd, Portage, WI 53901-9240 | 2019-07-17 |
| 1780236067 | Danielle Debruyne | Physical Therapist | 2817 New Pinery Rd, Portage, WI 53901-9240 | 2019-07-16 |
| 1063077055 | Dillon Via | Physician Assistant | 2817 New Pinery Rd, Portage, WI 53901-9240 | 2019-05-06 |
| 1659843886 | Andrew Benton Padley | Registered Nurse | 2817 New Pinery Rd, Portage, WI 53901-9240 | 2018-12-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740710748 | Robert James Corliss | Internal Medicine | St. Vincent Fmc, 140east Cook St., Portage, WI 53901 | 2017-06-13 |
| 1639328867 | Casey Jo Ambort | Speech-Language Pathologist | 626 East Slifer St, Portage, WI 53901 | 2008-09-11 |
| 1871767400 | Planned Parenthood of Wi, Inc | Non-Pharmacy Dispensing Site | 132 W. Cook St., Portage, WI 53901 | 2008-04-15 |
| 1881872158 | Marta Jean Jindra | Physical Therapist | 626 E Slifer Street, Portage, WI 53901 | 2008-02-08 |
| 1699953976 | Lana Marie Edwards | Speech-Language Pathologist | 626 East Slifer Street, Portage, WI 53901 | 2008-02-08 |
| 1134314552 | Kristina Hellenbrand | Physical Therapist | 2639 New Pinery Road, Suite 2, Portage, WI 53901 | 2007-09-10 |
| 1689727810 | Gregory Allan Bindl | Chiropractor | 2121new Pinery Rd, Portage, WI 53901 | 2007-01-19 |
| 1720149156 | Timothy J Rosin Dds Sc | Dentist | 2570 New Pinery Rd, Portage, WI 53901 | 2006-12-12 |
| 1710083779 | Currani Seubert Dental Office LLC | Dentist | 260 W Cook St, Portage, WI 53901 | 2006-09-16 |
| 1225090525 | University of Wisconsin Medical Foundation Inc | Durable Medical Equipment & Medical Supplies | 2977 Cty Hwy Cx, Portage, WI 53901 | 2006-04-04 |
| Find all providers in zip 53901 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134774524 | Antonio Richard Barron | Physician Assistant | 5717 Oakland Dr Ste A, Portage, MI 49024 | 2019-08-03 |
| 1609069566 | Jacqueline J James | Physician Assistant | 3000 Old Centre Road, Southwest Michigan Dermatology, A Division of Paragon H, Portage, MI 49024 | 2007-08-23 |
| 1528150893 | Michael Maurice Claussen | Physician Assistant | 3200 W Centre St, Suite 203, Portage, MI 49024 | 2006-09-28 |
| 1568425973 | Paige Jennifer Hickson | Physician Assistant | 6100 Newport Road, Suite 100, Kalamazoo Dermatology, P.C., Portage, MI 49002-9235 | 2006-04-07 |
| 1215917836 | Shanae A Hanoute | Physician Assistant | 2600 W Centre Ave, Portage, MI 49024-4828 | 2006-01-19 |
| 1003479445 | Brittany Rose Doxey | Physician Assistant | 1324 W Milham Ave, Portage, MI 49024-2239 | 2019-04-22 |
| 1902387962 | Amelia Louise Evenhouse | Physician Assistant | 3850 Glenkerry Ct, Portage, MI 49024-0700 | 2018-08-27 |
| 1932658184 | Kayla Chapman | Physician Assistant | 3000 Old Centre Rd, Portage, MI 49024 | 2016-09-29 |
| 1689056376 | Kristen Marie Moran | Physician Assistant | 7901 Angling Rd, Portage, MI 49024-0714 | 2015-06-18 |
| 1710389853 | Shantel Lynn Bleeker | Physician Assistant | 3304 Cooley Ct, Portage, MI 49024 | 2014-09-19 |
| Find all providers in PORTAGE | ||||
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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.