MR. SCOTT MICHAEL PETHAN (NPI# 1598039943) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1598039943 |
| Entity Type | Individual |
| Full Name | MR. SCOTT MICHAEL PETHAN |
| Credential | MS, BSN, RN |
| Practice Address |
2700 W 9th Ave Suite 107 Oshkosh WI 54904-7247 |
| Practice Telephone | 9202361835 |
| Practice Fax Number | 9202231182 |
| Mailing Telephone | 9202361835 |
| Mailing Fax Number | 9202231182 |
| Enumeration Date | 2012-03-02 |
| Last Update Date | 2012-03-02 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 224Y00000X | Clinical Exercise Physiologist | 136064-30 | WI | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
2700 W 9TH AVE SUITE 107 |
| City | OSHKOSH |
| State | WI |
| Zip Code | 54904-7247 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598762841 | Nathan C Meloy | Anesthesiology | 2700 W 9th Ave, Suite 205, Oshkosh, WI 54904-7247 | 2005-07-01 |
| 1629547633 | Tosha Wright | Nurse Practitioner | 2700 W 9th Ave, Oshkosh, WI 54904-7247 | 2018-11-19 |
| 1265897821 | Nicole M Edwards | Specialist/Technologist | 2700 W 9th Ave, Suite 125, Oshkosh, WI 54904-7247 | 2015-12-28 |
| 1316331960 | Jelena Kravic Shadick | Pediatrics | 2700 W 9th Ave, Oshkosh, WI 54904 | 2015-03-21 |
| 1811390180 | Kelyn O'brien | Nurse Practitioner | 2700 W 9th Ave, Oshkosh, WI 54904-7247 | 2014-10-01 |
| 1700286192 | Jill Kahler | Clinical Exercise Physiologist | 2700 W 9th Ave, Suite 107, Oshkosh, WI 54904-7247 | 2014-09-04 |
| 1578963096 | Gretta C. Grube | Nurse Practitioner | 2700 W 9th Ave, Oshkosh, WI 54904-7247 | 2014-09-03 |
| 1225448681 | Kelly E O'connor | Advanced Practice Midwife | 2700 W 9th Ave, Ste 230, Oshkosh, WI 54904-7247 | 2014-05-06 |
| 1992070650 | Julia E Salomon | Dietitian, Registered | 2700 W 9th Ave, Oshkosh, WI 54904-7247 | 2012-03-14 |
| 1023386950 | Tracy Ann Herrewig | Clinical Exercise Physiologist | 2700 W 9th Ave, Suite 107, Oshkosh, WI 54904-7247 | 2011-12-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326567140 | Mary Kay Benotsch | Registered Nurse | 505 South Washburn Street, Oshkosh, WI 54904 | 2017-09-13 |
| 1295278356 | Braden Williams | Nurse Anesthetist, Certified Registered | 955 Pheasant Creek Dr, Oshkosh, WI 54904 | 2016-11-22 |
| 1740651330 | Ams of Wisconsin - Oshkosh | Clinic/Center | 595 South Washburn St, Oshkosh, WI 54904 | 2015-10-08 |
| 1174990253 | Kaochi Desjheannette Vang | Occupational Therapist | Aurora Medical Center of Oshkosh - Rehab, 855 N. Westhaven Drive, Oshkosh, WI 54904 | 2015-08-25 |
| 1326453200 | Chey V Collura | Surgery | 2700 W 9th Ave Ste 310, Oshkosh, WI 54904 | 2014-06-30 |
| 1275847543 | Eden Rehabilitation Suites and Green House Homes, Inc. | Skilled Nursing Facility | 3151 Eden Court, Oshkosh, WI 54904 | 2010-07-29 |
| 1700043502 | Eric Koehler | Physical Therapist | 3475 Omro Rd Ste 300, Oshkosh, WI 54904 | 2008-05-20 |
| 1831396167 | Angela Marie Wade | Behavioral Analyst | 2986 Fitchburg Ct., Oshkosh, WI 54904 | 2007-06-29 |
| 1174642383 | Michael Gerard Bell | Dentist | 1795 West Pointe Dr, Oshkosh, WI 54904 | 2007-03-28 |
| 1235253030 | Jessica Anne Bielmeier | Registered Nurse | 2700 West 9th Ave #125, Oshkosh, WI 54904 | 2007-03-19 |
| Find all providers in zip 54904 | ||||
| Taxonomy Code | 224Y00000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Clinical Exercise Physiologist |
| A Clinical Exercise Physiologist is a health care professional who is trained to work with patients with chronic disease where exercise training has been shown to be of therapeutic benefit, including but not limited to cardiovascular and pulmonary disease, and metabolic disorders. |
| Notes: Source: What is a Clinical Exercise Physiologist? Clinical Exercise Physiology Association (CEPA), CEPA Executive Board, 2008 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700286192 | Jill Kahler | Clinical Exercise Physiologist | 2700 W 9th Ave, Suite 107, Oshkosh, WI 54904-7247 | 2014-09-04 |
| 1023386950 | Tracy Ann Herrewig | Clinical Exercise Physiologist | 2700 W 9th Ave, Suite 107, Oshkosh, WI 54904-7247 | 2011-12-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235407834 | Eric Douglas Thunstedt | Clinical Exercise Physiologist | 507 S. Main Street, Vernon Memorial Healthcare, Viroqua, WI 54665-2059 | 2011-12-09 |
| 1114294998 | Graceanne Forsyth-krajna | Clinical Exercise Physiologist | W148n8204 University Dr, Menomonee Falls, WI 53051-3826 | 2011-11-22 |
| 1386256246 | Brooke Alyssa Crossen | Clinical Exercise Physiologist | 2501 W Beltline Hwy Ste 207, Madison, WI 53713-2321 | 2020-08-20 |
| 1457995201 | Nicole Lee Dempsey | Clinical Exercise Physiologist | 2000 N Dewey Ave, Reedsburg, WI 53959-1049 | 2019-11-05 |
| 1770023137 | Chad Johnson | Clinical Exercise Physiologist | 1700 W Stout St, Rice Lake, WI 54868 | 2017-03-06 |
| 1619429735 | Lance Maerz | Clinical Exercise Physiologist | 800 Compassion Way, Dodgeville, WI 53533-1956 | 2016-10-25 |
| 1346799129 | Erin Barwick | Clinical Exercise Physiologist | 202 S Park St, Madison, WI 53715-1507 | 2016-09-22 |
| 1861850364 | Elan Inez Van Vlack | Clinical Exercise Physiologist | 2501 W Beltline Hwy Ste 207, Madison, WI 53713-2321 | 2016-01-29 |
| 1417347725 | Katherine Thompson | Clinical Exercise Physiologist | 1506 S Oneida St, Appleton, WI 54915-1305 | 2015-01-26 |
| 1548662281 | Brianna Roberts | Clinical Exercise Physiologist | 1506 S Oneida St, Attn: Cardiac and Pulmonary Rehab, Appleton, WI 54915-1305 | 2014-09-25 |
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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.