DR. TIMOTHY I MULLIN (NPI# 1588752307) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588752307 |
| Entity Type | Individual |
| Full Name | DR. TIMOTHY I MULLIN |
| Credential | M.D. |
| Practice Address |
1700 W Paradise Dr Orthopaedic Surgery West Bend WI 53095-9795 |
| Practice Telephone | 2623343451 |
| Practice Fax Number | 2623262964 |
| Mailing Telephone | 2623343451 |
| Mailing Fax Number | 2623262964 |
| Enumeration Date | 2006-10-10 |
| Last Update Date | 2014-12-31 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207X00000X | Orthopaedic Surgery | 48489 - 20 | WI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | LICENSE | 48489 | 01 |
| WI | 1588752307 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356413660 | Timothy Michael Mullin | Social Worker | 592 Rio Lindo Avenue, Chico, CA 95926 | 2006-11-14 |
| Street Address |
1700 W PARADISE DR ORTHOPAEDIC SURGERY |
| City | WEST BEND |
| State | WI |
| Zip Code | 53095-9795 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811980568 | Mark R Meuler | Optometrist | 1700 W Paradise Dr, West Bend, WI 53095-9795 | 2005-08-29 |
| 1902405186 | Ashley Renee Miller | Physical Therapist | 1700 W Paradise Dr, West Bend, WI 53095-9795 | 2020-10-20 |
| 1114552312 | Emily Hope Gorman | Registered Nurse | 1700 W Paradise Dr, West Bend, WI 53095-9795 | 2020-03-08 |
| 1992354823 | Froedtert Health Pharmacy LLC | Pharmacy | 1700 W Paradise Dr, West Bend, WI 53095-9795 | 2019-09-04 |
| 1184180994 | Jennifer Jean Schmidt | Nurse Practitioner | 1700 W Paradise Dr, West Bend, WI 53095-9795 | 2019-02-17 |
| 1770055782 | Lori Jo Dauss | Specialist/Technologist | 1700 W Paradise Dr, West Bend, WI 53095-9795 | 2019-01-02 |
| 1851808059 | Allison Danielle Kaczmarek | Nurse Practitioner | 1700 W Paradise Dr, West Bend, WI 53095-9795 | 2018-01-09 |
| 1306360409 | Jeremiah Christian Parve | Nurse Practitioner | 1700 W Paradise Dr, West Bend, WI 53095-9795 | 2017-07-31 |
| 1124540372 | Leslie Ann Weiss Russo | Physician Assistant | 1700 W Paradise Dr, West Bend, WI 53095-9795 | 2017-07-10 |
| 1134656374 | Daniela Aleman | Family Medicine | 1700 W Paradise Dr, West Bend, WI 53095-9795 | 2017-05-18 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942820428 | David Fountain | Contractor | 726 Creedwood Lane, West Bend, WI 53095 | 2020-04-24 |
| 1922664358 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 1745 South Main St, West Bend, WI 53095 | 2019-05-10 |
| 1912423773 | Michelle R Prentice | Family Medicine | West Bend Health Center, 1700 W. Paradise Drive, West Bend, WI 53095 | 2017-08-14 |
| 1386165918 | Quad/med, LLC | Clinic/Center | 432 E. Washington St. #1115, West Bend, WI 53095 | 2017-07-05 |
| 1508230632 | Jesen Daniel | Counselor | 111 East Washington St, Affiliated Clinical Services, West Bend, WI 53095 | 2015-12-01 |
| 1477965259 | Jenna Crofts | Specialist/Technologist | 1190 East Paradise Drive, West Bend, WI 53095 | 2014-05-28 |
| 1023436342 | Visionworks | Optometrist | 1437 S. Main St., West Bend, WI 53095 | 2014-04-03 |
| 1295157295 | Stephanie Rabe | Registered Nurse | 910 E. Paradise Drive, West Bend, WI 53095 | 2014-01-09 |
| 1477898815 | Ralph Norman Olsen | Pediatrics | 6267 Riesch Road, West Bend, WI 53095 | 2012-12-11 |
| 1932458536 | Joshua Aaron Barta | Dentist | 2090 Continental Drive, West Bend, WI 53095 | 2012-08-29 |
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| Taxonomy Code | 207X00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system. |
| 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 Orthopaedic Surgery, 2007. http://www.abos.org/. American Osteopathic Board of Orthopaedic Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Orthopaedic Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831196484 | John F Lesko | Orthopaedic Surgery | 6276 Gilbert Cir, West Bend, WI 53095-9197 | 2005-06-28 |
| 1568544393 | Mark T Omeara | Orthopaedic Surgery | 1700 W Paradise Dr, West Bend, WI 53095-9795 | 2006-10-20 |
| 1295817021 | Robert Manz | Orthopaedic Surgery | 1700 W Paradise Dr, West Bend, WI 53095-9795 | 2006-10-20 |
| 1386621878 | Michael Charles Reineck | Orthopaedic Surgery | 1201 Oak St, West Bend, WI 53095-3800 | 2005-12-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700486602 | Butler Orthopedics, LLP | Orthopaedic Surgery | 3237 S 16th St Ste 210, Milwaukee, WI 53215-4526 | 2020-10-29 |
| 1831729276 | Aspen Orthopedic and Rehabilation Specalist | Orthopaedic Surgery | 8907 S Howell Ave Ste 800, Oak Creek, WI 53154-4461 | 2020-01-24 |
| 1710520200 | Aspen Orthopedic and Rehabilation Specalist | Orthopaedic Surgery | 12555 W National Ave Ste 100, New Berlin, WI 53151-4061 | 2019-10-28 |
| 1477015931 | Multiple Care of Wi II, LLC | Orthopaedic Surgery | 8040 Excelsior Dr Ste 400, Madison, WI 53717-2915 | 2019-04-03 |
| 1508321209 | Ellen M Obrien | Orthopaedic Surgery | 5026 N Northwood Trce, Janesville, WI 53545-8990 | 2019-02-06 |
| 1487180238 | Ryan Scott Bailey | Orthopaedic Surgery | 7708 Milwaukee Ave, Wauwatosa, WI 53213-2209 | 2017-05-11 |
| 1932584927 | Anne Margarethe Ryan | Orthopaedic Surgery | 5940 Wild Rose Ln, Eau Claire, WI 54701-8783 | 2015-07-20 |
| 1003202631 | Bellin Memorial Hospital Inc | Orthopaedic Surgery | 218 So Hwy 141, Crivitz, WI 54114-1636 | 2015-04-10 |
| 1952728206 | Jacob R Seiler | Orthopaedic Surgery | 1205 West American Drive, Neenah, WI 54956-1405 | 2014-03-25 |
| 1770920472 | Jonathan Stone | Orthopaedic Surgery | 3111 W Rawson Ave Ste 200205, Franklin, WI 53132-9417 | 2013-06-04 |
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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.