NICKY PLEMENTOSH (NPI# 1467461053) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467461053 |
| Entity Type | Individual |
| Full Name | NICKY PLEMENTOSH |
| Credential | M.D. |
| Practice Address |
1537 Park Pl Ste 200 Green Bay WI 54304-1974 |
| Mailing Address |
744 S Webster Ave Green Bay WI 54301-3505 |
| Practice Telephone | 9204988650 |
| Practice Fax Number | 9204980945 |
| Mailing Telephone | 9204457226 |
| Mailing Fax Number | 9204457229 |
| Enumeration Date | 2006-08-05 |
| Last Update Date | 2018-06-19 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207V00000X | Obstetrics & Gynecology | 44280-020 | WI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 34186800 | 05 |
| Street Address |
1537 PARK PL STE 200 |
| City | GREEN BAY |
| State | WI |
| Zip Code | 54304-1974 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285634899 | Angela Lamack | Physician Assistant | 1537 Park Pl Ste 200, Green Bay, WI 54304-1974 | 2005-07-26 |
| 1740572031 | Pamela A Pamperin | Registered Nurse | 1537 Park Pl Ste 200, Green Bay, WI 54304-1974 | 2011-05-05 |
| 1124276100 | Paulette J Doperalski | Specialist/Technologist, Other | 1537 Park Pl Ste 200, Green Bay, WI 54304-1974 | 2008-09-03 |
| 1992808166 | Bellin Health Physical Therapy Obgyn | Clinic/Center | 1537 Park Pl Ste 200, Green Bay, WI 54304-1974 | 2006-09-06 |
| 1164431862 | Women's Health Care, Ob-gyn, S.c. | Obstetrics & Gynecology | 1537 Park Pl Ste 200, Green Bay, WI 54304-1974 | 2006-08-05 |
| 1073522637 | Kathlene A Kusiv | Obstetrics & Gynecology | 1537 Park Pl Ste 200, Green Bay, WI 54304-1974 | 2006-08-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689196255 | Kristen Ashley Haltom | Registered Nurse | 2979 Allied St Suite C, Green Bay, WI 54304 | 2017-07-14 |
| 1649671421 | Heather Marie Novak | Counselor | 2979 Allied St Unit C, Green Bay, WI 54304 | 2014-09-11 |
| 1356777684 | Nathan Weir | Specialist/Technologist | 1265 Lombardi Avenue, Green Bay, WI 54304 | 2013-09-18 |
| 1922349927 | John W Hartman | Internal Medicine | 916 Willard Dr, Suite 200, Green Bay, WI 54304 | 2013-03-15 |
| 1447551379 | Citralina M Haruo | Community Health Worker | 1110 11th Avenue, Green Bay, WI 54304 | 2010-11-09 |
| 1497061352 | Daniel James Gustin | Pharmacist | 1109 Lombardi Ave, Green Bay, WI 54304 | 2010-08-28 |
| 1316259898 | Karen A Detrick | Occupational Therapy Assistant | 1040 Pilgram Way, Woodside Senior Communities, Green Bay, WI 54304 | 2010-07-13 |
| 1861667362 | Planned Parenthood of Wi, Inc | Non-Pharmacy Dispensing Site | 2605 S. Oneida St. Suite 107, Green Bay, WI 54304 | 2008-04-25 |
| 1891967303 | Kimberley M Welk | Marriage & Family Therapist | 926 Willard Dr Ste 136, Green Bay, WI 54304 | 2008-03-25 |
| 1750563698 | Richard Lawrence Beyer | Hearing Instrument Specialist | 2154 S Ridge Rd, Green Bay, WI 54304 | 2007-12-03 |
| Find all providers in zip 54304 | ||||
| Taxonomy Code | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952626905 | Amy Katherine Schueckler | Obstetrics & Gynecology | 301 N Webster Ave, Green Bay, WI 54301-4815 | 2010-04-01 |
| 1508096017 | Anna J Igler | Obstetrics & Gynecology | 2253 W Mason St Ste 300, Green Bay, WI 54303-4706 | 2009-07-17 |
| 1255364667 | Brian Dale Dobbins | Obstetrics & Gynecology | 2890 Lineville Rd, Green Bay, WI 54313-7202 | 2006-07-09 |
| 1083682876 | Cheryl L Bailey | Obstetrics & Gynecology | 720 S Vanburen St, Suite 101, Green Bay, WI 54301-3504 | 2006-03-09 |
| 1134645542 | Bellin Memorial Hospital | Obstetrics & Gynecology | 2641 Development Dr, Green Bay, WI 54311-4240 | 2017-08-17 |
| 1841672516 | Bellin Memorial Hospital Inc | Obstetrics & Gynecology | 704 S Webster Ave, Suite 100 B, Green Bay, WI 54301-3533 | 2015-06-18 |
| 1902210925 | Ryan D Kuefler | Obstetrics & Gynecology | 720 S Vanburen St, Green Bay, WI 54301-3504 | 2014-06-18 |
| 1649407412 | Amy Van Gheem | Obstetrics & Gynecology | 1715 Dousman St, Green Bay, WI 54303-3211 | 2009-06-18 |
| 1407082381 | Sara Helena Tikkanen Swift | Obstetrics & Gynecology | 2845 Greenbrier Rd, Green Bay, WI 54311 | 2009-06-05 |
| 1457518532 | Jory A Ough | Obstetrics & Gynecology | 2641 Development Dr, Green Bay, WI 54311-4240 | 2008-05-17 |
| Find all providers in GREEN BAY | ||||
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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.