DOUGLAS RADTKE (NPI# 1407396013) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407396013 |
| Entity Type | Individual |
| Full Name | DOUGLAS RADTKE |
| Credential | LMT, BCTMB |
| Practice Address |
6233 Bankers Rd Suite 12 Mount Pleasant WI 53403-9700 |
| Mailing Address |
6233 Bankers Rd Sitte 12 Mount Pleasant WI 53403-9700 |
| Practice Telephone | 2623586730 |
| Mailing Telephone | 2623586730 |
| Enumeration Date | 2017-03-01 |
| Last Update Date | 2017-03-01 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 405300000X | Prevention Professional | 4994-146 | WI | Other Service Providers |
| Street Address |
6233 BANKERS RD SUITE 12 |
| City | MOUNT PLEASANT |
| State | WI |
| Zip Code | 53403-9700 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982601704 | Steven L Armus | Dermatology | 6233 Bankers Rd, Suite 3, Mount Pleasant, WI 53403-9700 | 2005-07-07 |
| 1811438930 | Sanan LLC | Home Health | 6233 Bankers Rd, Suite 18-e, Mount Pleasant, WI 53403-9700 | 2017-03-09 |
| 1649664434 | Merit Dermatology, S.c. | Surgery | 6233 Bankers Rd, Suite 20, Mount Pleasant, WI 53403-9700 | 2015-03-19 |
| 1134460066 | Branko Prpa Md LLC | Orthopaedic Surgery | 6233 Bankers Rd, Suite 11, Mount Pleasant, WI 53403-9700 | 2013-03-01 |
| 1235414665 | Kimberly A Schwerdtfeger | Nurse Practitioner | 6233 Bankers Rd, Suite 3, Mount Pleasant, WI 53403-9700 | 2011-10-17 |
| 1851467047 | Great Lakes Dermatology Sc | Dermatology | 6233 Bankers Rd, Suite 3, Mount Pleasant, WI 53403-9700 | 2006-11-28 |
| 1851315733 | Ronald L. Smits | Dermatology | 6233 Bankers Rd, Ste 3, Mount Pleasant, WI 53403-9700 | 2006-07-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124676259 | Quality Care LLC | Clinic/Center | 2051 Mead St, Racine, WI 53403 | 2019-09-02 |
| 1073999355 | Wisconsin Lutheran Child & Family Service, Inc. | Social Worker | 6150 Taylor Avenue, Racine, WI 53403 | 2015-08-10 |
| 1457780496 | Pheynell Branch | Counselor | 1650 Wasington Ave, Racine, WI 53403 | 2013-11-08 |
| 1811278054 | Michelle Gloria Parisot | Psychologist | 1320 Wisconsin Ave., Racine, WI 53403 | 2011-09-01 |
| 1720372022 | Katie Hagen | Social Worker | 1717 Taylor Avenue, Racine, WI 53403 | 2011-06-03 |
| 1043431570 | Rita S Harris | Physical Therapy Assistant | Lakeshore Manor 1320 Wisconsin Avenue, Racine, WI 53403 | 2007-05-01 |
| 1336281336 | Linda J Hockensmith | Occupational Therapist | 4214 Sheridan Road, Racine, WI 53403 | 2007-02-13 |
| 1851447387 | Richard John Kemper | Dentist | 1509 Washington Ave, Racine, WI 53403 | 2007-01-26 |
| 1689760332 | Lester Leslie Higgenbottom | Counselor | 1820 Arlington Ave, Racine, WI 53403 | 2006-10-04 |
| 1114942315 | Access Medical Center, LLC | Clinic/Center | 4216 Old Green Bay Rd, Racine, WI 53403 | 2006-07-12 |
| Find all providers in zip 53403 | ||||
| Taxonomy Code | 405300000X |
| Grouping | Other Service Providers |
| Classification | Prevention Professional |
| Prevention Professionals work in programs aimed to address specific patient needs, such as suicide prevention, violence prevention, alcohol avoidance, drug avoidance, and tobacco prevention. The goal of the program is to reduce the risk of relapse, injury, or re-injury of the patient. Prevention Professionals work in a variety of settings and provide appropriate case management, mediation, referral, and mentorship services. Individuals complete prevention professionals training for the population of patients with whom they work. |
| Notes: Source: National Uniform Claim Committee, 2015 [1/1/2016: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326679663 | Andrea Maria Dosedla | Prevention Professional | N61w23044 Harrys Way, Sussex, WI 53089-3995 | 2020-01-27 |
| 1063981710 | Jon Maurice Smoots | Prevention Professional | 7710 W. Casper Street, Milwaukee, WI 53216 | 2018-11-23 |
| 1023527769 | Red Road House | Prevention Professional | 152 S Locust St, Janesville, WI 53548-3767 | 2017-09-26 |
| 1164963187 | Anna Lanman | Prevention Professional | 303 12th Ave, Baraboo, WI 53913-1612 | 2017-03-09 |
| 1659819076 | Haley Jacob | Prevention Professional | 1725 State St, 126 Mitchell Hall, La Crosse, WI 54601-3742 | 2017-02-06 |
| 1043627912 | Sonia Porter | Prevention Professional | 5151 W Silver Spring Dr, Milwaukee, WI 53218-3300 | 2014-07-12 |
| City | MOUNT PLEASANT |
| Zip Code | 53403 |
Please comment or provide details below to improve the information on DOUGLAS RADTKE.
| 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.