MR. BRYANT RANDALL KEARNEY (NPI# 1366725541) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366725541 |
| Entity Type | Individual |
| Full Name | MR. BRYANT RANDALL KEARNEY |
| Credential | PAC |
| Practice Address |
705 S University Ave Ste 150 Beaver Dam WI 53916-3053 |
| Mailing Address |
705 South University Ave Ste 150 Beaver Dam WI 53916-3041 |
| Practice Telephone | 9208852663 |
| Practice Fax Number | 9208852466 |
| Mailing Telephone | 9208852663 |
| Mailing Fax Number | 9208852466 |
| Enumeration Date | 2011-09-23 |
| Last Update Date | 2011-09-23 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363AM0700X |
Physician Assistant Specialization: Medical |
2836-023 | WI | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
2836-023 | WI | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
705 S UNIVERSITY AVE STE 150 |
| City | BEAVER DAM |
| State | WI |
| Zip Code | 53916-3053 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558354068 | Paul R Mcmillan | Family Medicine | 705 S University Ave, Suite 200, Beaver Dam, WI 53916-3053 | 2005-08-30 |
| 1043786296 | Sherry Bisbee | Pharmacist | 705 S University Ave, Beaver Dam, WI 53916-3053 | 2018-10-15 |
| 1831549005 | Natalie Ross | Registered Nurse | 705 S University Ave, Suite 300, Beaver Dam, WI 53916-3053 | 2016-06-17 |
| 1770979650 | Bethany N Perry | Nurse Practitioner | 705 S University Ave, Suite 500, Beaver Dam, WI 53916-3053 | 2015-04-08 |
| 1639569585 | Sean Thuesen | Specialist/Technologist | 705 S University Ave, Beaver Dam, WI 53916-3053 | 2015-01-30 |
| 1871847731 | Ronay Bjerke | Pharmacist | 705 S University Ave, Suite 180, Beaver Dam, WI 53916-3053 | 2012-10-30 |
| 1578845202 | Peggy A Katsma | Nurse Practitioner | 705 S University Ave, Suite 200, Beaver Dam, WI 53916-3053 | 2011-09-20 |
| 1164712014 | Catherine Em Nelson | Family Medicine | 705 S University Ave, Suite 500, Beaver Dam, WI 53916-3053 | 2011-04-12 |
| 1306146972 | Jessica Ann Nehls-rennhack | Nurse Practitioner | 705 S University Ave, Suite 500, Beaver Dam, WI 53916-3053 | 2010-10-28 |
| 1205143302 | Jayme K Quade | Registered Nurse | 705 S University Ave, Ste 510, Beaver Dam, WI 53916-3053 | 2010-09-10 |
| Find all providers in the same location | ||||
| 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 | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871091207 | Ryan Patrick Gallagher | Physician Assistant | 707 S University Ave, Beaver Dam, WI 53916-3027 | 2018-01-31 |
| 1619420932 | Caleb Mabis | Physician Assistant | 707 S University Ave, Beaver Dam, WI 53916-3027 | 2016-08-03 |
| 1609065085 | Luke Lentscher | Physician Assistant | 250 Corporate Dr, Beaver Dam, WI 53916 | 2007-10-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821612045 | Cassidy Renee Thomas | Physician Assistant | 1111 Delafield St Ste 209, Waukesha, WI 53188-3403 | 2020-06-03 |
| 1982056768 | Luke Harbers | Physician Assistant | 6226 Bankers Rd Ste 11, Mount Pleasant, WI 53403-9799 | 2016-07-06 |
| 1093085664 | Abraham David Pacheco | Physician Assistant | 3246 S 35th St, Milwaukee, WI 53215-4156 | 2012-01-12 |
| 1346577954 | Darren Rosser | Physician Assistant | 2931 S 108th St, West Allis, WI 53227-3519 | 2009-11-03 |
| 1033359401 | Matthew S. Bay | Physician Assistant | 1818 N. Meade St Suite 240 West, Fox Valley Surgical Associates, Appleton, WI 54911-3496 | 2009-02-25 |
| 1265657068 | Surgical and Rehab Services Inc | Physician Assistant | E4051 Steven Way, Spring Green, WI 53588-9271 | 2007-04-16 |
| 1992844385 | Jill Ann Schumacher | Physician Assistant | 2265 90th St, Eau Claire, WI 54703-0181 | 2007-02-05 |
| 1609915073 | Brian Felix Robinson | Physician Assistant | S725 Turner Valley Rd, Mondovi, WI 54755-8331 | 2007-02-05 |
| 1124176383 | William Henry Price | Physician Assistant | 4819 5th Ave, Unit 2, Kenosha, WI 53140-2924 | 2007-01-06 |
| 1619032919 | Michael R Depew | Physician Assistant | 1650 S. 41st St., Lakeshore Orthopedics, Manitowoc, WI 54220 | 2006-12-27 |
| Find all providers with the same taxonomy | ||||
| City | BEAVER DAM |
| Zip Code | 53916 |
Please comment or provide details below to improve the information on MR. BRYANT RANDALL KEARNEY.
| 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.