MR. KENNETH D SIMON (NPI# 1497008239) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497008239 |
| Entity Type | Individual |
| Full Name | MR. KENNETH D SIMON |
| Practice Address |
2511 Green Bay St La Crosse WI 54601-5900 |
| Mailing Address |
1325 Mississippi Dr Dakota MN 55925-7171 |
| Practice Telephone | 6087758585 |
| Mailing Telephone | 5076436677 |
| Enumeration Date | 2012-10-17 |
| Last Update Date | 2012-10-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 183500000X | Pharmacist | 114107 | MN | Pharmacy Service Providers |
| Y | 183500000X | Pharmacist | 9813-40 | WI | Pharmacy Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073502993 | Kenneth M Simon | Internal Medicine | 4255 Boy Scout Camp, New Smyrna Beach, FL 32168-8896 | 2005-10-14 |
| 1366725848 | Kenneth Simon | Surgery | 400 Veterans Ave, Biloxi, MS 39531-2410 | 2011-09-21 |
| Street Address |
2511 GREEN BAY ST |
| City | LA CROSSE |
| State | WI |
| Zip Code | 54601-5900 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154954071 | Gabrielle Thompson | Pharmacist | 2511 Green Bay St, La Crosse, WI 54601-5900 | 2020-02-19 |
| 1033686662 | Erika Rose Brown | Pharmacist | 2511 Green Bay St, La Crosse, WI 54601-5900 | 2018-11-01 |
| 1245705441 | Gundersen Clinic Ltd | Pharmacy | 2511 Green Bay St, La Crosse, WI 54601-5900 | 2018-10-04 |
| 1225457385 | Katherine Stehly | Pharmacist | 2511 Green Bay St, La Crosse, WI 54601-5900 | 2014-04-15 |
| 1376880799 | Amy Rasmussen | Pharmacist | 2511 Green Bay St, La Crosse, WI 54601-5900 | 2013-01-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891324265 | Meagan Mcrae | Student in an Organized Health Care Education/Training Program | 1725 State St., 4051 Health Science Center, La Crosse, WI 54601 | 2020-04-07 |
| 1255969671 | Erin Dingman | Student in an Organized Health Care Education/Training Program | 1751 State Street, 4051 Health Science Center, La Crosse, WI 54601 | 2020-03-31 |
| 1619505047 | Nicole Kay Lynch | Student in an Organized Health Care Education/Training Program | 4051 Health Science Center, 1725 State St, La Crosse, WI 54601 | 2020-03-31 |
| 1174151757 | Jenna Sells | Student in an Organized Health Care Education/Training Program | 4051 Health Science Center, 1725 State Street, La Crosse, WI 54601 | 2020-03-30 |
| 1740818301 | Katie Irene Tahtinen | Student in an Organized Health Care Education/Training Program | Uwl- 4051 Health Science Center, 1725 State St., La Crosse, WI 54601 | 2020-03-30 |
| 1932737517 | Margaret May Grimm | Student in an Organized Health Care Education/Training Program | Univesity of Wisconsin-la Crosse, 4051 Health Science Center, 1725 State Street, La Crosse, WI 54601 | 2020-03-30 |
| 1831727312 | Matthew Timothy Axler | Student in an Organized Health Care Education/Training Program | 4051 Health Science Center, 1725 State Street, La Crosse, WI 54601 | 2020-03-30 |
| 1093340473 | Denise Stinson | Technician | 1311 Badger St, Apt 505, La Crosse, WI 54601 | 2020-03-06 |
| 1922632397 | Ibrahim Ahsan | Pharmacist | 1105 Wi-16, La Crosse, WI 54601 | 2020-02-25 |
| 1750913356 | Liza R Collins | Massage Therapist | 1415 State Wi 16, La Crosse, WI 54601 | 2020-02-11 |
| Find all providers in zip 54601 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922632397 | Ibrahim Ahsan | Pharmacist | 1105 Wi-16, La Crosse, WI 54601 | 2020-02-25 |
| 1487013819 | Angela Podevels | Pharmacist | 2415 State Rd, La Crosse, WI 54601-6137 | 2016-02-12 |
| 1548693435 | Nichole Ashley Finney | Pharmacist | 2617 Main St., La Crosse, WI 54601 | 2013-08-14 |
| 1730420175 | Angela Brandl | Pharmacist | 2325 Mississippi St, La Crosse, WI 54601-5128 | 2013-03-11 |
| 1548537517 | Patrick Halton | Pharmacist | 321 S 19th St, La Crosse, WI 54601 | 2011-11-19 |
| 1477837839 | Nathaniel W Berndt | Pharmacist | 4415 State Road 16, La Crosse, WI 54601-1815 | 2011-10-04 |
| 1982986345 | Christopher W Hutchinson | Pharmacist | 2626 Rose Street, La Crosse, WI 54603 | 2011-09-12 |
| 1891964037 | Robert Marlin Schwandt | Pharmacist | N2014 Valley Rd, La Crosse, WI 54601-7116 | 2008-02-21 |
| 1306999396 | Jerry Leonard Glocke | Pharmacist | 2442 State Rd, La Crosse, WI 54601-6155 | 2007-01-21 |
| 1245247642 | James D Lukas | Pharmacist | 724 Denton St, La Crosse, WI 54601-5447 | 2006-08-01 |
| Find all providers in LA CROSSE | ||||
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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.