PREVEA (NPI# 1417300518) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417300518 |
| Entity Type | Organization |
| Organization Name | PREVEA |
| Other Organization Name | PREVEA SHEBOYGAN |
| Practice Address |
1411 N Taylor Dr Sheboygan WI 53081-3043 |
| Practice Telephone | 9208031598 |
| Mailing Telephone | 9208031598 |
| Enumeration Date | 2016-07-13 |
| Last Update Date | 2016-07-13 |
| Authorized Official Name | MRS. AMBER GOLEMBESKI (NURSE PRACTITIONER) |
| Authorized Official Telephone | 9202078119 |
| Authorized Official Credential | RN |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
149367 | WI | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Prevea Sheboygan | Doing Business As Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | PREVEA HEALTH SERVICES | 2710 Executive Dr, Green Bay, WI 54304-5496 |
| System for Award Management (SAM) Entities | PREVEAL TECHNOLOGIES, INC. | 104 W 40th Ave, Spokane, WA 99203-1534 |
| Washington State Corporations | PREVEAL TECHNOLOGIES, INC. | 104 W 40th Ave, Spokane, WA 99203-1534 |
| Colorado Business Entities | Preveal, LLC | 3980 Bunk House Drive, Colorado Springs, CO 80917 |
| Street Address |
1411 N TAYLOR DR |
| City | SHEBOYGAN |
| State | WI |
| Zip Code | 53081-3043 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063483543 | Karen Lu Colvin | Nurse Anesthetist, Certified Registered | 1411 N Taylor Dr, Sheboygan, WI 53081-3043 | 2006-01-31 |
| 1235753922 | Elizabeth Grace Garncarz | Physician Assistant | 1411 N Taylor Dr, Sheboygan, WI 53081-3043 | 2020-05-29 |
| 1649827163 | Alice Chanakira-alimi | Physician Assistant | 1411 N Taylor Dr, Sheboygan, WI 53081-3043 | 2019-08-20 |
| 1821582016 | Lauren Sheafer | Physician Assistant | 1411 N Taylor Dr, Sheboygan, WI 53081-3043 | 2018-06-20 |
| 1033603774 | Marlee Anne Hall | Physician Assistant | 1411 N Taylor Dr, Sheboygan, WI 53081-3043 | 2018-06-16 |
| 1386180362 | Amy Sue Gumieny | Nurse Practitioner | 1411 N Taylor Dr, Sheboygan, WI 53081-3043 | 2017-01-13 |
| 1841687365 | Tina N Ozbeki | Family Medicine | 1411 N Taylor Dr, Sheboygan, WI 53081-3043 | 2015-04-22 |
| 1346668936 | St Nicholas Hospital-sisters of The Third Order of St Francis | Durable Medical Equipment & Medical Supplies | 1411 N Taylor Dr, Sheboygan, WI 53081-3043 | 2014-04-01 |
| 1093145773 | Marylou Mercado | Registered Nurse | 1411 N Taylor Dr, Sheboygan, WI 53081-3043 | 2013-11-18 |
| 1770922320 | Derek Schenk | Specialist/Technologist, Other | 1411 N Taylor Dr, Sheboygan, WI 53081-3043 | 2013-06-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770053696 | Kathy Hughes Counseling, LLC | Community/Behavioral Health | 630 Riverfront Dr Ste 203, Sheboygan, WI 53081 | 2018-12-04 |
| 1780159004 | Great Lakes Clinic and Consultants, LLC | Clinic/Center | 1407 North 8th Street, Suite 203, Sheboygan, WI 53081 | 2018-10-13 |
| 1174032106 | Laura Elizabeth Manning | Registered Nurse | 325 Linocln Ave, Sheboygan, WI 53081 | 2017-09-21 |
| 1043733686 | Chasidy D Wilke | Behavioral Analyst | 2223 Terrace View Dr Apt 3a, Sheboygan, WI 53081 | 2017-07-25 |
| 1700320074 | Darlene Wilken | Counselor | 2842 S. Business Dr, Sheboygan, WI 53081 | 2016-12-06 |
| 1942652185 | Jacob Steven Son | Dentist | 3555 Wasington Ave., Sheboygan, WI 53081 | 2016-07-12 |
| 1225491749 | Cassandra Lea Loehndorf | Social Worker | 3321 S. 12th St., Sheboygan, WI 53081 | 2016-04-01 |
| 1003201112 | Jason Meinhardt | Dentist | 2115 S Memorial Pl, Sheboygan, WI 53081 | 2015-04-06 |
| 1346634110 | Christopher Lenz | Specialist/Technologist | 2920 Superior Ave., Prevea Orthopedics, Sheboygan, WI 53081 | 2015-03-19 |
| 1780008060 | James Simac | Counselor | 503 Wisconsin Ave., Sheboygan, WI 53081 | 2014-02-07 |
| Find all providers in zip 53081 | ||||
| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
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|---|---|---|---|---|
| 1174122097 | Whole You Acupuncture and Health Consulting LLC | Clinic/Center | 3330 University Ave Ste 205, Madison, WI 53705-2167 | 2020-10-21 |
| 1588275036 | Abifka Healthcare Inc. | Clinic/Center | 8725 S Wood Creek Dr, Oak Creek, WI 53154-7502 | 2020-08-10 |
| 1306483508 | Achieve Wellness Clinic | Clinic/Center | 1417 Winchester Way, Suite 6, Altoona, WI 54720-5472 | 2019-12-06 |
| 1386295061 | Careatc | Clinic/Center | 1400 E Wisconsin St, Delavan, WI 53115-1470 | 2019-09-24 |
| 1295386977 | Careatc | Clinic/Center | 4600 W Loomis Rd Ste 200, Greenfield, WI 53220-4858 | 2019-09-24 |
| 1639728496 | Quad/med, LLC | Clinic/Center | 725 South Street, Mayville, WI 53050 | 2019-09-05 |
| 1316505464 | New Richmond Family Care, LLC | Clinic/Center | 1500 Madison Ave # 5c, New Richmond, WI 54017-6693 | 2019-06-04 |
| 1609433705 | Activate Healthcare | Clinic/Center | 660 Vandeberg St, Baldwin, WI 54002-3251 | 2019-05-23 |
| 1043703838 | Interra Health Inc. | Clinic/Center | 5 Innovation Ct Ste B, Appleton, WI 54914-1739 | 2018-06-07 |
| 1942792254 | Quad/med, LLC | Clinic/Center | 1900 W. Sumner Street, Hartford, WI 53027 | 2018-06-01 |
| Find all providers with the same taxonomy | ||||
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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.