SUSAN H KRECKMAN (NPI# 1376527002) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376527002 |
| Entity Type | Individual |
| Full Name | SUSAN H KRECKMAN |
| Credential | MD |
| Practice Address |
2817 New Pinery Rd. Divine Savior Healthcare, Inc. Portage WI 53901-0387 |
| Practice Telephone | 6087454598 |
| Practice Fax Number | 6087456242 |
| Mailing Telephone | 6087454598 |
| Mailing Fax Number | 6087456242 |
| Enumeration Date | 2005-12-06 |
| Last Update Date | 2011-10-14 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 39356 | WI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 32379600 | 05 |
| Street Address |
2817 NEW PINERY RD. DIVINE SAVIOR HEALTHCARE, INC. |
| City | PORTAGE |
| State | WI |
| Zip Code | 53901-0387 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669472858 | James J Foskett | Orthopaedic Surgery | 2817 New Pinery Rd., Divine Savior Heathcare, Inc., Portage, WI 53901-0387 | 2005-07-28 |
| 1013171727 | Kelly Rae Toijala | Physician Assistant | 2817 New Pinery Rd., Divine Savior Healthcare, Inc, Portage, WI 53901-0387 | 2008-07-11 |
| 1538142765 | Kenneth K Oh | Physical Medicine & Rehabilitation | 2817 New Pinery Rd., Divine Savior Healthcare Inc, Portage, WI 53901-0387 | 2005-11-22 |
| 1619950888 | Charles L Boursier | Emergency Medicine | 2817 New Pinery Rd., Divine Savior Healthcare Inc, Portage, WI 53901-0387 | 2005-11-22 |
| 1336122506 | Darcy L Steinhorst | Physician Assistant | 2817 New Pinery Rd., Divine Savior Healthcare Inc, Portage, WI 53901-0387 | 2005-11-22 |
| 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 | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831576693 | Bishara Robert Khoury | Family Medicine | 3545 Arbor Blvd Ste E, Portage, IN 46368 | 2015-04-30 |
| 1659567956 | Family Health Center Inc. | Family Medicine | 325 E Centre Ave, Portage, MI 49002-5512 | 2007-09-20 |
| 1679663603 | Stephen V Headley | Family Medicine | 3283 Willowcreek Rd, Portage, IN 46368 | 2006-10-13 |
| 1023114477 | Carolyn Von Maur | Family Medicine | 7901 Angling Road, Suite B-201, Portage, MI 49024 | 2006-09-15 |
| 1013029883 | Primary Care PC | Family Medicine | 3125 Willowcreek Road, Portage, IN 46368 | 2006-08-31 |
| 1467490300 | Northshore Health Centers, Inc. | Family Medicine | 6450 Us Highway 6, Portage, IN 46368-5110 | 2006-06-03 |
| 1578518437 | Vpa PC | Family Medicine | 5104 Lovers Ln, Portage, MI 49002-1558 | 2006-05-22 |
| 1992769285 | Jeffrey M Stevens | Family Medicine | 2725 Airview Blvd Ste 105, Portage, MI 49002 | 2006-04-13 |
| 1598724106 | Beatriz Somoza-blanco | Family Medicine | 2977 County Road Cx, Portage, WI 53901 | 2006-03-22 |
| 1912973942 | Andrew Taylor Putney | Family Medicine | 2901 Hunters Trl, Portage, WI 53901-3403 | 2006-02-28 |
| 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.