JAMES ROBERT EBBEN (NPI# 1497730865) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497730865 |
| Entity Type | Individual |
| Full Name | JAMES ROBERT EBBEN |
| Credential | MD |
| Practice Address |
1970 S Ridge Rd Green Bay WI 54304-4125 |
| Mailing Address |
Po Box 22487 Green Bay WI 54305-2487 |
| Practice Telephone | 9204304888 |
| Practice Fax Number | 9204304889 |
| Mailing Telephone | 9204457226 |
| Mailing Fax Number | 9204457238 |
| Enumeration Date | 2005-12-08 |
| Last Update Date | 2020-03-02 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | 29793 | WI | Allopathic & Osteopathic Physicians |
| Y | 207QS0010X |
Family Medicine Specialization: Sports Medicine |
29793-20 | WI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | LICENSE | 29793 | 01 |
| AMERICAN BOARD OF FAMILY MEDICINE-SPORTS MEDICINE | 354601 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1630 Commanche Ave, Green Bay, WI 543135753 | 9204304700 |
| Street Address |
1970 S RIDGE RD |
| City | GREEN BAY |
| State | WI |
| Zip Code | 54304-4125 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326021288 | Robert Bentley Anderson | Orthopaedic Surgery | 1970 S Ridge Rd, Green Bay, WI 54304-4125 | 2005-11-23 |
| 1467062208 | Carli Megan Tebo | Specialist/Technologist | 1970 S Ridge Rd, Green Bay, WI 54304-4125 | 2020-08-06 |
| 1306463716 | Chase A Nier | Physical Therapist | 1970 S Ridge Rd, Green Bay, WI 54304-4125 | 2020-07-01 |
| 1801433255 | Daniel Joel Sabin | Specialist/Technologist | 1970 S Ridge Rd, Green Bay, WI 54304-4125 | 2019-12-04 |
| 1528603537 | Erik Uhl | Specialist/Technologist | 1970 S Ridge Rd, Green Bay, WI 54304-4125 | 2019-11-13 |
| 1285279448 | Hayley Reinke | Specialist/Technologist | 1970 S Ridge Rd, Green Bay, WI 54304-4125 | 2019-11-12 |
| 1881243285 | Briana Louise Gates | Nurse Practitioner | 1970 S Ridge Rd, Green Bay, WI 54304-4125 | 2019-09-09 |
| 1972157840 | Jacob E Lanzendorf | Occupational Therapist | 1970 S Ridge Rd, Green Bay, WI 54304-4125 | 2019-07-30 |
| 1497318489 | Bellin Psychiatric Center Inc | Social Worker | 1970 S Ridge Rd, Green Bay, WI 54304-4125 | 2019-04-16 |
| 1457866063 | Alexa Lee Schillinger | Physician Assistant | 1970 S Ridge Rd, Green Bay, WI 54304-4125 | 2017-12-05 |
| Find all providers in the same location | ||||
| 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 | 207QS0010X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Specialization | Sports Medicine |
| A family medicine physician that is trained to be responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention of injury and illness. A sports medicine physician must have knowledge and experience in the promotion of wellness and the prevention of injury. Knowledge about special areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation, injuries (treatment and prevention and referral practice) and the role of exercise in promoting a healthy lifestyle are essential to the practice of sports medicine. The sports medicine physician requires special education to provide the knowledge to improve the health care of the individual engaged in physical exercise (sports) whether as an individual or in team participation. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Family Medicine, 2007. http://www.theabfm.org/. American Osteopathic Board of Family Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689220527 | Delo Sport and Stem Sc | Family Medicine | 2595 Development Dr Ste 140, Green Bay, WI 54311-4267 | 2019-08-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811203706 | Matthew M Brown | Family Medicine | 1705 Hoffman St, Madison, WI 53704-2510 | 2010-08-30 |
| 1174764906 | Mark W Niedfeldt, Md, LLC | Family Medicine | 10556 N Port Washington Rd, Ste 101, Mequon, WI 53092-5586 | 2009-03-06 |
| 1225151558 | Patrick Earl Mcdonough | Family Medicine | 235 State Street, St. Croix Falls, WI 54024 | 2007-04-10 |
| 1790858462 | Shanyn Colleen Lancaster | Family Medicine | 1250 W Wisconsin Ave, Student Health, Schroeder Complex, Lower Level, Milwaukee, WI 53233-2225 | 2006-11-17 |
| 1306919907 | Steven Alan Giles | Family Medicine | 3316 Ridgeline Dr, Waukesha, WI 53188 | 2006-11-15 |
| 1417377755 | Todd Domeyer | Family Medicine | 3113 Saemann Ave, Sheboygan, WI 53081 | 2014-04-25 |
| 1972949501 | Chad Joseph Giles | Family Medicine | 4100 State Highway 66, Stevens Point, WI 54482 | 2013-05-22 |
| 1073956363 | Lucianne Helena Olewinski | Family Medicine | Uw Hospital and Clinics, 600 Highland Ave, Madison, WI 53792-0001 | 2013-04-17 |
| 1902166978 | Jessica L Juntunen | Family Medicine | 5200 Hummingbird Rd, Suite 100, Wausau, WI 54401-6312 | 2012-05-23 |
| 1255607057 | John Charles Pick-jacobs | Family Medicine | 7401 104th Ave Ste 110, Kenosha, WI 53142 | 2012-03-26 |
| 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.