DR. ETHAN NATHANIEL MCFADDIN (NPI# 1386274413) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1386274413 |
Entity Type | Individual |
Full Name | DR. ETHAN NATHANIEL MCFADDIN |
Credential | PHARMD |
Practice Address |
10400 75th St Kenosha WI 53142-7884 |
Practice Telephone | 2629487040 |
Mailing Telephone | 2629487040 |
Enumeration Date | 2020-01-16 |
Last Update Date | 2020-01-16 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 183500000X | Pharmacist | 20196-40 | WI | Pharmacy Service Providers |
Street Address |
10400 75TH ST |
City | KENOSHA |
State | WI |
Zip Code | 53142-7884 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1477546737 | Mea-aea Kenosha Sc | Family Medicine | 10400 75th St, Kenosha, WI 53142-7884 | 2005-08-23 |
1548877707 | Megan Labine | Dietitian, Registered | 10400 75th St, Kenosha, WI 53142-7884 | 2020-09-30 |
1730796574 | Saralyn Paredes | Nurse Practitioner | 10400 75th St, Kenosha, WI 53142-7884 | 2020-09-25 |
1518586965 | Ariel Adelsen | Registered Nurse | 10400 75th St, Kenosha, WI 53142-7884 | 2020-04-15 |
1134757073 | Amber Jirschele | Nurse Practitioner | 10400 75th St, Kenosha, WI 53142-8323 | 2020-03-27 |
1912539974 | Kristina A Roscizewski | Nurse Practitioner | 10400 75th St, Kenosha, WI 53142-7884 | 2020-02-07 |
1972133031 | Patricia Grzyb | Physician Assistant | 10400 75th St, Kenosha, WI 53142-7884 | 2020-01-16 |
1144873654 | Lauren Cornejo | Occupational Therapist | 10400 75th St, Kenosha, WI 53142-8323 | 2019-07-23 |
1245710771 | Brenda Joyce Woodhull | Registered Nurse | 10400 75th St, Kenosha, WI 53142-7884 | 2018-08-15 |
1851877633 | Sara Ann Muench | Dietitian, Registered | 10400 75th St, Kenosha, WI 53142-7884 | 2018-07-16 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1588297816 | Caring Hearts Home Health Care | In Home Supportive Care | 6021-57th Ave, Suite C103, Kenosha, WI 53142 | 2020-02-14 |
1144785395 | Michael L Wrzesinski | Counselor | 4109 67th Street, Kenosha, WI 53142 | 2019-02-01 |
1720538499 | David Smith | Counselor | 10900 67th Street, Kenosha, WI 53142 | 2016-10-06 |
1326404641 | Smile Doctors Ltd | Dentist | 7003 39th Ave, Kenosha, WI 53142 | 2016-01-04 |
1225409485 | Antonia Marie Decker | Physician Assistant | 10400 75th St. Ste 204, Kenosha, WI 53142 | 2015-10-14 |
1780060582 | Joshua Haas | Pharmacist | 7701 Green Bay Road, Kenosha, IL 53142 | 2015-08-04 |
1811379225 | Dana Mary Stout | Registered Nurse | 7401 104th Avenue, Suite 110, Comprehensive Orthopaedics, S.c., Kenosha, WI 53142 | 2015-06-22 |
1669815569 | Joshua Knute Elson | Radiology | 6811 118th Ave, Kenosha, WI 53142 | 2013-04-10 |
1356610166 | Michael J Gallo | Pharmacist | 7535 North Greenbay Rd, Kenosha, WI 53142 | 2011-12-22 |
1720357999 | Orest Carnevale | Registered Nurse | 7316 155th Ct, Kenosha, WI 53142 | 2011-12-18 |
Find all providers in zip 53142 |
Taxonomy Code | 183500000X |
Grouping | Pharmacy Service Providers |
Classification | Pharmacist |
An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1174122576 | Paul Suiven Mbinglo | Pharmacist | 6237 94th Ct, Kenosha, WI 53142-8225 | 2020-10-19 |
1215400031 | Philip C Berce | Pharmacist | 3535 30th Ave Ste 103, Kenosha, WI 53144-1632 | 2019-01-03 |
1124488457 | Laurie Birchell | Pharmacist | 9310 128th Ave, Kenosha, WI 53142-7338 | 2016-02-29 |
1780060582 | Joshua Haas | Pharmacist | 7701 Green Bay Road, Kenosha, IL 53142 | 2015-08-04 |
1366829947 | Madonna Eileen Janas-foreman | Pharmacist | 3207 80th St Ste 100, Kenosha, WI 53142-4908 | 2015-05-02 |
1306286935 | Mehul N Patel | Pharmacist | 7111 104th Ave Unit H, Kenosha, WI 53142-8302 | 2013-06-27 |
1932547999 | Gregory J Sitter | Pharmacist | 3825 39th Ave, Suite #100, Kenosha, WI 53144-5314 | 2013-06-11 |
1366796559 | James Kanetzke | Pharmacist | 5300 52nd Street, Kenosha, WI 53144-2398 | 2012-11-09 |
1356610166 | Michael J Gallo | Pharmacist | 7535 North Greenbay Rd, Kenosha, WI 53142 | 2011-12-22 |
1790052777 | Anupama Potineni | Pharmacist | 7535 N Greenbay Rd, Kenosha, WI 53142-1871 | 2011-11-19 |
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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.