JACQUELINE NICOLE MAXAM (NPI# 1407055528) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407055528 |
| Entity Type | Individual |
| Full Name | JACQUELINE NICOLE MAXAM |
| Other Name | JACQUELINE NICOLE FRENCH |
| Practice Address |
1520 N Meade St Appleton WI 54911-3762 |
| Practice Telephone | 9207347181 |
| Practice Fax Number | 9207340621 |
| Mailing Telephone | 9207347181 |
| Mailing Fax Number | 9207340621 |
| Enumeration Date | 2007-07-18 |
| Last Update Date | 2011-10-12 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 231H00000X | Audiologist | 471-156 | WI | Speech, Language and Hearing Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 41150900 | 05 |
| Street Address |
1520 N MEADE ST |
| City | APPLETON |
| State | WI |
| Zip Code | 54911-3762 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487646675 | Matthew Edward Bettag | Otolaryngology | 1520 N Meade St, Appleton, WI 54911-3762 | 2005-08-16 |
| 1629294145 | Michael James Mcavoy | Otolaryngology | 1520 N Meade St, Appleton, WI 54911-3762 | 2007-04-17 |
| 1699791285 | Heather L Totman | Audiologist-Hearing Aid Fitter | 1520 N Meade St, Appleton, WI 54911-3762 | 2006-07-15 |
| 1629094214 | Ear Nose & Throat Surgical Associates Sc | Specialist | 1520 N Meade St, Appleton, WI 54911-3762 | 2006-07-15 |
| 1457343642 | Mitchell Francis Kwaterski | Otolaryngology | 1520 N Meade St, Appleton, WI 54911-3762 | 2005-08-16 |
| 1295727345 | Steven James Vandenberg | Otolaryngology | 1520 N Meade St, Appleton, WI 54911-3762 | 2005-08-16 |
| 1801888011 | Kent Carlton Schaefer | Otolaryngology | 1520 N Meade St, Appleton, WI 54911-3762 | 2005-08-16 |
| 1508858721 | Kristin K Borgen | Audiologist | 1520 N Meade St, Appleton, WI 54911-3762 | 2005-08-16 |
| 1659363877 | Jessica M Jenkins-werner | Audiologist | 1520 N Meade St, Appleton, WI 54911-3762 | 2005-08-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912545633 | Brotherly Love, LLC | Day Training, Developmentally Disabled Services | 1513 E Frances St, Appleton, WI 54911 | 2019-12-12 |
| 1952952129 | Eagle Point Senior Living Inc | Assisted Living Facility | 995 East John Street, Appleton, WI 54911 | 2019-09-27 |
| 1619524766 | University Rx LLC | Pharmacy | 133 E College Ave, Appleton, WI 54911 | 2019-08-23 |
| 1174080063 | Shayla Russell | Counselor | Outagamie County Health and Human Services, 320 S. Walnut St., Appleton, WI 54911 | 2019-02-27 |
| 1871086645 | Megan Kilsdonk | Health Educator | 1604 N Meade St, Appleton, WI 54911 | 2018-06-07 |
| 1871085480 | Tanya Lynn Vickery | Social Worker | 410 S. Elm St., Appleton, WI 54911 | 2018-05-31 |
| 1013407501 | Teri G Metropulos | Counselor | 229 S. Morrison, Appleton, WI 54911 | 2018-05-10 |
| 1093211211 | Bonnie Anne Korytkowski | Student in an Organized Health Care Education/Training Program | 229 S. Morrison Street, Appleton, WI 54911 | 2018-04-05 |
| 1639673940 | Brett Follett | Psychologist | 401 S. Elm St., Appleton, WI 54911 | 2018-03-21 |
| 1700202892 | Brian Withrow | Counselor | 607 West 7th St., Appleton, WI 54911 | 2014-03-13 |
| Find all providers in zip 54911 | ||||
| Taxonomy Code | 231H00000X |
| Grouping | Speech, Language and Hearing Service Providers |
| Classification | Audiologist |
| (1) A specialist in evaluation, habilitation and rehabilitation of those whose communication disorders center in whole or in part in hearing function. Audiologists are autonomous professionals who identify, assess, and manage disorders of the auditory, balance and other neural systems. Audiologists provide audiological (aural) rehabilitation to children and adults across the entire age span. Audiologists select, fit and dispense amplification systems such as hearing aids and related devices. (2) An audiologist is a person qualified by a master’s degree in audiology, licensed by the state, where applicable, and practicing within the scope of that license. Audiologists evaluate and treat patients with impaired hearing. They plan, direct and conduct rehabilitative programs with audiotry substitutional devises (hearing aids) and other therapy. |
| Notes: Source: (1) American Speech-Language-Hearing Association, (1996, Spring) Scope of practice in Audiology, p. 2 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073866224 | Connect Hearing, Inc. | Audiologist | 128 W Sorenson Ave, Appleton, MN 56208-4505 | 2012-10-24 |
| 1598890139 | Barbara Jean Johnson | Audiologist | 506 E Longview Dr Ste A, Appleton, WI 54911-2105 | 2007-02-23 |
| 1023153251 | Peter John Zellmer | Audiologist | 1336 E Wisconsin Ave, Appleton, WI 54911-3969 | 2007-02-21 |
| 1750308649 | Robert R Broeckert | Audiologist | 4650 W Spencer St, Suite 31, Appleton, WI 54914-9106 | 2006-07-16 |
| 1083105530 | Audiology and Hearing Services of The Fox Cities | Audiologist | 2245 S Oneida St, Appleton, WI 54915 | 2018-05-21 |
| 1194177683 | Brittany Uitenbroek | Audiologist | W3124 Van Roy Rd, Appleton, WI 54915 | 2016-07-07 |
| 1770972697 | Kyle Martell | Audiologist | 1336 E Wisconsin Ave, Appleton, WI 54911-3969 | 2015-01-15 |
| 1497063515 | Thomas Robert Parry | Audiologist | 2245 S Oneida St, Appleton, WI 54915-1657 | 2010-09-23 |
| 1861725418 | Stacey D Dimond | Audiologist | 1440 Oneida St, N, Appleton, WI 54915-7101 | 2009-09-15 |
| 1336314814 | Stephanie Roberts Long | Audiologist | W3124 Van Roy Rd, Appleton, WI 54915-3982 | 2008-04-25 |
| Find all providers in APPLETON | ||||
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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.