MARK WILLIAM DANTUMA (NPI# 1407322084) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1407322084 |
Entity Type | Individual |
Full Name | MARK WILLIAM DANTUMA |
Credential | APNP |
Practice Address |
3200 E Racine St Janesville WI 53546-2343 |
Mailing Address |
500 W 190th St Ste 400 Gardena CA 90248-4269 |
Practice Telephone | 6083718000 |
Practice Fax Number | 6083718939 |
Mailing Telephone | 7144521961 |
Enumeration Date | 2018-10-22 |
Last Update Date | 2020-11-06 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | 8782-33 | WI | Physician Assistants & Advanced Practice Nursing Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
WI | 1407322084 | 05 |
Street Address |
3200 E RACINE ST |
City | JANESVILLE |
State | WI |
Zip Code | 53546-2343 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1124026208 | Mark C. Torres | Obstetrics & Gynecology | 3200 E Racine St, Janesville, WI 53546-2343 | 2005-07-12 |
1033719703 | Macy G Bolt | Physical Therapist | 3200 E Racine St, Janesville, WI 53546-2343 | 2020-10-30 |
1407489016 | Joy P. Thompson | Nurse Practitioner | 3200 E Racine St, Janesville, WI 53546-2343 | 2020-02-21 |
1851938419 | Hatsuho Wilkinson | Dietitian, Registered | 3200 E Racine St, Janesville, WI 53546-2343 | 2019-12-03 |
1013563394 | Karrie R Lynch | Nurse Practitioner | 3200 E Racine St, Janesville, WI 53546-2343 | 2019-08-13 |
1679128771 | Ellen Jean Ettlie | Nurse Practitioner | 3200 E Racine St, Janesville, WI 53546-2343 | 2019-08-06 |
1881249126 | Elizabeth F Ramer | Nurse Practitioner | 3200 E Racine St, Janesville, WI 53546-2343 | 2019-08-05 |
1093377905 | Nichole N Clark | Nurse Practitioner | 3200 E Racine St, Janesville, WI 53546-2343 | 2019-07-01 |
1386202448 | Nicole M. Wentzien | Physical Therapist | 3200 E Racine St, Janesville, WI 53546-2343 | 2019-06-04 |
1083199418 | Rebecca L Wergin | Nurse Practitioner | 3200 E Racine St, Janesville, WI 53546-2343 | 2018-10-02 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1366911489 | Latoya Christina Anderson | Counselor | 1818 Pershing Pl, Janesville, WI 53546 | 2018-11-19 |
1922599216 | Megan Arney | Speech-Language Pathologist | 9680, 4445 Woodgate Dr., Janesville, WI 53546 | 2018-05-23 |
1770089955 | Abby Marie Harnack | Registered Nurse | 3901 Teal Ln, Janesville, WI 53546 | 2018-04-05 |
1962773648 | Clark Carroll | Nurse Practitioner | 1820 Center Ave, Janesville, WI 53546 | 2012-01-26 |
1689983793 | Fve Mw LLC | Assisted Living Facility | 3801 North Wright Road, Janesville, WI 53546 | 2010-10-07 |
1831354794 | County of Rock County Clerk | Community/Behavioral Health | 3506 Hwy 51, Janesville, WI 53546 | 2008-07-21 |
1528225422 | Walgreen Co | Pharmacy | 2519 Kettering St, Janesville, WI 53546 | 2008-05-19 |
1447420351 | Michele Renee Bohland | Physical Therapy Assistant | 2540 Humes Rd, Janesville, WI 53546 | 2008-03-06 |
1093992158 | Emma Gene Harrell | Counselor | 203 W Sunny Lane, Janesville, WI 53546 | 2008-01-30 |
1457473696 | Robert Louis Fleming | Dentist | 910 Conde St, Janesville, WI 53546 | 2007-04-06 |
Find all providers in zip 53546 |
Taxonomy Code | 363L00000X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1407489016 | Joy P. Thompson | Nurse Practitioner | 3200 E Racine St, Janesville, WI 53546-2343 | 2020-02-21 |
1013563394 | Karrie R Lynch | Nurse Practitioner | 3200 E Racine St, Janesville, WI 53546-2343 | 2019-08-13 |
1679128771 | Ellen Jean Ettlie | Nurse Practitioner | 3200 E Racine St, Janesville, WI 53546-2343 | 2019-08-06 |
1881249126 | Elizabeth F Ramer | Nurse Practitioner | 3200 E Racine St, Janesville, WI 53546-2343 | 2019-08-05 |
1093377905 | Nichole N Clark | Nurse Practitioner | 3200 E Racine St, Janesville, WI 53546-2343 | 2019-07-01 |
1083199418 | Rebecca L Wergin | Nurse Practitioner | 3200 E Racine St, Janesville, WI 53546-2343 | 2018-10-02 |
1437662574 | Dayna C Osborne | Nurse Practitioner | 1000 Mineral Point Ave, Janesville, WI 53548-2940 | 2017-11-12 |
1235656976 | Amanda L Kilcoyne | Nurse Practitioner | 3200 E Racine St, Janesville, WI 53546-2343 | 2017-08-24 |
1972025021 | Heidi M. Rye | Nurse Practitioner | 3200 E Racine St, Janesville, WI 53546-2343 | 2017-07-11 |
1932648771 | Courtney E Castelein | Nurse Practitioner | 1000 Mineral Point Ave, Janesville, WI 53548-2940 | 2017-02-13 |
Find all providers in JANESVILLE |
City | JANESVILLE |
Zip Code | 53546 |
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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.