BRADLEY ALLEN LOCKE (NPI# 1336300276) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1336300276 |
Entity Type | Individual |
Full Name | BRADLEY ALLEN LOCKE |
Credential | D.O. |
Practice Address |
2793 Lineville Rd Green Bay WI 54313-7152 |
Practice Telephone | 9204964700 |
Mailing Telephone | 9204964700 |
Enumeration Date | 2008-06-23 |
Last Update Date | 2014-08-05 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 208000000X | Pediatrics | 55834 | WI | Allopathic & Osteopathic Physicians |
Y | 2080P0201X |
Pediatrics Specialization: Pediatric Allergy/Immunology |
55834-020 | WI | Allopathic & Osteopathic Physicians |
Street Address |
2793 LINEVILLE RD |
City | GREEN BAY |
State | WI |
Zip Code | 54313-7152 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1932172053 | Susan Frangiskakis | Specialist | 2793 Lineville Rd, Green Bay, WI 54313-7152 | 2006-02-09 |
1063026276 | Matthew John Sprister | Nurse Practitioner | 2793 Lineville Rd, Green Bay, WI 54313-7152 | 2020-09-04 |
1780215251 | Christine Hyde | Nurse Practitioner | 2793 Lineville Rd, Green Bay, WI 54313-7152 | 2020-02-03 |
1275049140 | Miranda Mary Cseter | Physician Assistant | 2793 Lineville Rd, Green Bay, WI 54313-7152 | 2017-12-14 |
1205205424 | Jennifer N. Charles | Registered Nurse | 2793 Lineville Rd, Green Bay, WI 54313-7152 | 2015-09-17 |
1316222771 | Tiffany Lynn Laughlin | Nurse Practitioner | 2793 Lineville Rd, Green Bay, WI 54313-7152 | 2011-10-18 |
1720217722 | St Vincent Hospital-hospital Sisters-third Order of St Francis | Durable Medical Equipment & Medical Supplies | 2793 Lineville Rd, Green Bay, WI 54313-7152 | 2009-07-11 |
1154563229 | Joshua D Rankin | Pediatrics | 2793 Lineville Rd, Green Bay, WI 54313-7152 | 2009-04-03 |
1003080102 | Mark Andrew Kachan | Podiatrist | 2793 Lineville Rd, Green Bay, WI 54313-7152 | 2008-04-18 |
1013197979 | Mariruth Neff | Nurse Practitioner | 2793 Lineville Rd, Green Bay, WI 54313-7152 | 2007-11-08 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1548823420 | Martha Lynn Drew | Licensed Practical Nurse | 3101 Molly Brown Lane, Green Day, WI 54313 | 2019-04-17 |
1831691872 | Melanie Hammerbeck | Dentist | 1756 Cardinal Ln, Green Bay, WI 54313 | 2018-03-06 |
1649727108 | Amanda Marie Mckeefry | Dental Hygienist | 2304 Lineville Rd, Suite 101, Green Bay, WI 54313 | 2016-09-01 |
1326594813 | Kaylee Schartner | Dental Hygienist | 2304 Lineville Road, Suite 100, Suamico, WI 54313 | 2016-08-25 |
1134500226 | Salvanz Enterprises Inc | Pharmacy | 2673 Lineville Road, Green Bay, WI 54313 | 2015-06-15 |
1467849307 | Maureen Riordan | Specialist/Technologist | 2957 S Telemark Cir., Green Bay, WI 54313 | 2015-04-17 |
1043556780 | Kellen James Binder | Chiropractor | 2638 Tulip Lane, Suite B, Green Bay, WI 54313 | 2012-12-28 |
1407092737 | Sara Ann Anderson | Registered Nurse | 2691 Shade Tree Ln, Green Bay, WI 54313 | 2008-12-16 |
1467601344 | Melissa Lea Socha | Speech-Language Pathologist | 2153 School Lane, Suamiro Elementary, Green Bay, WI 54313 | 2008-09-16 |
1003070707 | Anne Marie Hein | Physical Therapist | 3101 S Packerland Dr, Green Bay, WI 54313 | 2008-07-11 |
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Taxonomy Code | 2080P0201X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Pediatrics |
Specialization | Pediatric Allergy/Immunology |
A pediatrician who specializes in the diagnosis and treatment of allergies, allergic reactions, and immunologic diseases in children. |
Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: title modified, definition added, source added] Additional Resources: A Certification of Special Qualifications (CSQ) is issued by the American Osteopathic Board of Pediatrics. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1104893312 | Robert F Lemanske Jr. | Pediatrics | 3515 Sunset Dr, Madison, WI 53705-1430 | 2006-03-07 |
1659613263 | Samantha Mae Knox | Pediatrics | 1836 South Ave, La Crosse, WI 54601 | 2013-03-21 |
1780959924 | Eric Michael Schauberger | Pediatrics | 451 Junction Rd, Madison, WI 53717 | 2012-03-21 |
1699004812 | Sima K Ramratnam | Pediatrics | 1675 Highland Ave, Madison, WI 53792-0001 | 2009-12-17 |
1629118211 | Katherine Ann Gonzaga | Pediatrics | 6408 Copps Ave, Monona, WI 53716-3702 | 2007-02-06 |
1013920297 | Kristen Volkman | Pediatrics | 8500 75th St, Suite 101, Kenosha, WI 53142-8213 | 2006-08-15 |
1770592545 | Eli M. Eisenstein | Pediatrics | 9000 W Wisconsin Ave, Milwaukee, WI 53226-3518 | 2006-08-07 |
1003823923 | Daniel J Jackson | Pediatrics | 600 Highland Ave, Csc Box 9988, Madison, WI 53792-0001 | 2006-08-02 |
1396792891 | John M. Routes | Pediatrics | 9000 W Wisconsin Ave, Pediatric Allery and Immunology, Milwaukee, WI 53226-4874 | 2006-05-28 |
1780634840 | Anne Marie Singh | Pediatrics | 451 Junction Rd, Madison, WI 53717-2656 | 2006-05-11 |
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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.