JAMES EDWARD MEMMEN (NPI# 1356367023) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356367023 |
| Entity Type | Individual |
| Full Name | JAMES EDWARD MEMMEN |
| Credential | MD |
| Practice Address |
1543 Park Pl Suite 400 Green Bay WI 54304-1970 |
| Mailing Address |
Po Box 10946 Green Bay WI 54307-0946 |
| Practice Telephone | 9204970100 |
| Practice Fax Number | 9204970101 |
| Mailing Telephone | 9203800100 |
| Mailing Fax Number | 9203800101 |
| Enumeration Date | 2006-07-14 |
| Last Update Date | 2020-03-10 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207W00000X | Ophthalmology | 29183 | WI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | DMCR / EYEGLASSES | 6343730001 | 01 |
| Street Address |
1543 PARK PL SUITE 400 |
| City | GREEN BAY |
| State | WI |
| Zip Code | 54304-1970 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679805642 | Best Optical LLC | Specialist | 1543 Park Pl, Suite 400, Green Bay, WI 54304-1970 | 2010-02-02 |
| 1104972033 | Brian M Thielen | Dentist | 1543 Park Pl, Suite 300, Green Bay, WI 54304-1970 | 2007-01-25 |
| 1396769576 | John Michael Fay II | Dentist | 1543 Park Pl, Green Bay, WI 54304-1970 | 2006-07-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689196255 | Kristen Ashley Haltom | Registered Nurse | 2979 Allied St Suite C, Green Bay, WI 54304 | 2017-07-14 |
| 1649671421 | Heather Marie Novak | Counselor | 2979 Allied St Unit C, Green Bay, WI 54304 | 2014-09-11 |
| 1356777684 | Nathan Weir | Specialist/Technologist | 1265 Lombardi Avenue, Green Bay, WI 54304 | 2013-09-18 |
| 1922349927 | John W Hartman | Internal Medicine | 916 Willard Dr, Suite 200, Green Bay, WI 54304 | 2013-03-15 |
| 1447551379 | Citralina M Haruo | Community Health Worker | 1110 11th Avenue, Green Bay, WI 54304 | 2010-11-09 |
| 1497061352 | Daniel James Gustin | Pharmacist | 1109 Lombardi Ave, Green Bay, WI 54304 | 2010-08-28 |
| 1316259898 | Karen A Detrick | Occupational Therapy Assistant | 1040 Pilgram Way, Woodside Senior Communities, Green Bay, WI 54304 | 2010-07-13 |
| 1861667362 | Planned Parenthood of Wi, Inc | Non-Pharmacy Dispensing Site | 2605 S. Oneida St. Suite 107, Green Bay, WI 54304 | 2008-04-25 |
| 1891967303 | Kimberley M Welk | Marriage & Family Therapist | 926 Willard Dr Ste 136, Green Bay, WI 54304 | 2008-03-25 |
| 1750563698 | Richard Lawrence Beyer | Hearing Instrument Specialist | 2154 S Ridge Rd, Green Bay, WI 54304 | 2007-12-03 |
| Find all providers in zip 54304 | ||||
| Taxonomy Code | 207W00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Ophthalmology |
| An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Ophthalmology, 2007. http://www.abop.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Ophthalmology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487703880 | Wisconsin Oculoplastics Ltd | Ophthalmology | 1525 Park Pl, Green Bay, WI 54304-1979 | 2007-01-09 |
| 1215039136 | Kurt August Schwiesow | Ophthalmology | 1087 W Mason Street, Green Bay, WI 54303-1859 | 2006-09-01 |
| 1992731327 | Marie D Nassiff | Ophthalmology | 4665 Wery Rd, Green Bay, WI 54311-9102 | 2006-06-25 |
| 1790720100 | Dianna L Bordewick | Ophthalmology | 2253 W Mason St Ste 100, Green Bay, WI 54303-4706 | 2006-06-19 |
| 1659336733 | Matthew J Thompson | Ophthalmology | 1087 W Mason St, #1, Green Bay, WI 54303-1859 | 2006-04-20 |
| 1316932197 | Pamela G Dobson | Ophthalmology | 211 N Broadway, Ste 103, Green Bay, WI 54303-2757 | 2005-09-16 |
| 1003808676 | Benjamin E Phillips | Ophthalmology | 164 N Broadway, Green Bay, WI 54303-2728 | 2005-08-18 |
| 1326042730 | Daniel L Dale | Ophthalmology | 1525 Park Place, Green Bay, WI 54304-1979 | 2005-06-13 |
| 1134440670 | William Joseph Reynders | Ophthalmology | 2253 W Mason St, Green Bay, WI 54303 | 2010-06-18 |
| 1841440138 | Dongmei Chen | Ophthalmology | 2253 W Mason St, Green Bay, WI 54303-4706 | 2008-09-24 |
| Find all providers in GREEN BAY | ||||
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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.