TIANA M IMHOFF (NPI# 1487094686) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487094686 |
| Entity Type | Individual |
| Full Name | TIANA M IMHOFF |
| Other Name | TIANA M WEISS |
| Credential | PA-C |
| Practice Address |
1515 Park Ave Columbus WI 53925 |
| Mailing Address |
1515 Park Ave Columbus WI 53925-1618 |
| Practice Telephone | 9206232200 |
| Mailing Telephone | 9206232200 |
| Enumeration Date | 2013-07-02 |
| Last Update Date | 2020-10-09 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
3158-23 | WI | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 1487094686 | 05 | |
| WI | BCBSWI | 1487094686 | 01 |
| WI | MERCYCARE INSURANCE | WEISSTIA | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 3524 E Milwaukee St, Janesville, WI 535461626 | 6087567100 | 6087564700 |
| Street Address |
1515 PARK AVE |
| City | COLUMBUS |
| State | WI |
| Zip Code | 53925 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720050909 | Veronica S Minier | Family Medicine | 1515 Park Ave, Columbus, WI 53925-1618 | 2006-02-02 |
| 1649804816 | Amanda Wedderspoon | Physician Assistant | 1515 Park Ave, Columbus, WI 53925-1618 | 2020-02-26 |
| 1316423361 | Lauren Autumn Sommer | Dietitian, Registered | 1515 Park Ave, Columbus, WI 53925-1618 | 2018-07-12 |
| 1861905846 | Prairie Ridge Health, Inc. | Pharmacy | 1515 Park Ave, Columbus, WI 53925-1618 | 2017-11-13 |
| 1043720105 | Stacy Biesel | Registered Nurse | 1515 Park Ave, Columbus, WI 53925-1618 | 2017-10-03 |
| 1437668613 | Columbus Community Hospital Inc | Non-Pharmacy Dispensing Site | 1515 Park Ave, Columbus, WI 53925-1618 | 2017-09-20 |
| 1962930719 | Rachel E Selm | Dietitian, Registered | 1515 Park Ave, Columbus, WI 53925-1618 | 2017-05-24 |
| 1598210247 | Stacey Depies | Physical Therapist | 1515 Park Ave, Columbus, WI 53925-1618 | 2016-08-23 |
| 1639623689 | Kimberly Schoenberger | Physical Therapist | 1515 Park Ave, Columbus, WI 53925-1618 | 2016-08-08 |
| 1942651955 | Asghar Marwat | Internal Medicine | 1515 Park Ave, Columbus, WI 53925-1618 | 2016-06-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275833659 | Beaver Dam Community Hosptials, Inc. | Family Medicine | 1580 W James St, Columbus, WI 53925 | 2010-11-01 |
| 1497972749 | Droessler Chiropractic Sc | Chiropractor | 1349 Park Avenue, Columbus, WI 53925 | 2007-04-19 |
| 1164487328 | Drs Beck & Becker Sc | Dentist | 1505 Park Ave., Columbus, WI 53925 | 2006-04-19 |
| 1245864735 | Margaret Mary Frank | Pharmacist | 1500 W James St, Columbus, WI 53925 | 2020-02-24 |
| 1821343401 | Shopko Stores Operating Co LLC | Eyewear Supplier (Equipment, not the service) | 200 Commerce Dr, Columbus, WI 53925 | 2012-07-19 |
| 1184723645 | James Michael Beck | Dentist | 1505 Park Ave., Columbus, WI 53925 | 2006-09-21 |
| 1194824649 | William James Becker | Dentist | 1505 Park Ave., Columbus, WI 53925 | 2006-09-21 |
| 1225004245 | Nazi S Khan | Internal Medicine | 1511 Park Ave, Columbus, WI 53925 | 2006-02-28 |
| 1689756157 | Walgreen Co | Pharmacy | 1500 W James St, Columbus, WI 53925-1001 | 2006-10-20 |
| 1770117327 | Mohammad Hamdan | Pharmacist | 1500 W James St, Columbus, WI 53925-1001 | 2020-02-22 |
| Find all providers in zip 53925 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861936155 | Surgical Fusion, LLC | Physician Assistant | 605 N High St # 237, Columbus, OH 43215-2024 | 2016-12-06 |
| 1114177722 | Malachi Hutto IIi | Physician Assistant | 2300a Manchester Express Way Suite 101a, St. Francis Orthopaedic Institute, Columbus, GA 31904 | 2008-09-19 |
| 1518167279 | Howard A. Paskett | Physician Assistant | 2050 Kenny Rd Ste 3300, Columbus, OH 43221-3502 | 2007-07-20 |
| 1346440286 | Mary Fisher Feldman | Physician Assistant | N-839 Doan Hall 410 West 10th Ave., Osu Thoracic Surgery, Columbus, OH 43210-1240 | 2007-07-19 |
| 1033190723 | Brian Douglas Foor | Physician Assistant | 3465 Macon Rd, Ste D, Columbus, GA 31907-2582 | 2005-11-09 |
| 1063031516 | Erik C Zimmer | Physician Assistant | 285 E State St Ste 260, Columbus, OH 43215-4322 | 2020-04-15 |
| 1023662327 | Emily L Sedler | Physician Assistant | 940 N Marr Rd Ste C, Columbus, IN 47201-2610 | 2019-07-25 |
| 1225500127 | Eric M Ladow | Physician Assistant | 285 E State St Ste 400, Columbus, OH 43215-4354 | 2018-12-18 |
| 1629581178 | Frehun Ayele Asele | Physician Assistant | 700 Childrens Dr, Columbus, OH 43205-2664 | 2017-11-07 |
| 1437674793 | Monica Faye Mills | Physician Assistant | 255 Baptist Blvd Ste 401, Columbus, MS 39705 | 2017-08-08 |
| Find all providers in COLUMBUS | ||||
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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.