FOND DU LAC PATHOLOGY CONSULTANTS (NPI# 1619052800) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619052800 |
| Entity Type | Organization |
| Organization Name | FOND DU LAC PATHOLOGY CONSULTANTS |
| Practice Address |
430 E Division St St Agnes Hosp, Pathology Dept Fond Du Lac WI 54935-4560 |
| Mailing Address |
Po Box 107 Fond Du Lac WI 54936-0107 |
| Practice Telephone | 9209265840 |
| Practice Fax Number | 9209290647 |
| Mailing Telephone | 9209299300 |
| Mailing Fax Number | 9209235260 |
| Enumeration Date | 2006-10-26 |
| Last Update Date | 2014-01-09 |
| Authorized Official Name | DR. JONATHAN GEDYE (PRESIDENT) |
| Authorized Official Telephone | 9209265800 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207ZP0102X |
Pathology Specialization: Anatomic Pathology & Clinical Pathology |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 31770700 | 05 | |
| WI | RR MEDICARE | CO1718 | 01 |
| Street Address |
430 E DIVISION ST ST AGNES HOSP, PATHOLOGY DEPT |
| City | FOND DU LAC |
| State | WI |
| Zip Code | 54935-4560 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437157831 | Gilberto Cantu | Nurse Anesthetist, Certified Registered | 430 E Division St, Fond Du Lac, WI 54935-4560 | 2005-07-09 |
| 1992306310 | Leah Timm | Nurse Practitioner | 430 E Division St, Fond Du Lac, WI 54935-4560 | 2020-11-03 |
| 1982212312 | Tiffany M Parker | Counselor | 430 E Division St, Fond Du Lac, WI 54935-4560 | 2020-07-22 |
| 1619594355 | Brynn Sytsma | Student in an Organized Health Care Education/Training Program | 430 E Division St, Fond Du Lac, WI 54935-4560 | 2020-06-29 |
| 1891312633 | Joshua Mckinney | Counselor | 430 E Division St, Fond Du Lac, WI 54935-4560 | 2020-06-27 |
| 1275153264 | Jacalyn Lucille Wendt Coleman | Dietitian, Registered | 430 E Division St, Fond Du Lac, WI 54935-4560 | 2020-04-20 |
| 1568090884 | Jaclyn R Monteverde | Physician Assistant | 430 E Division St, Fond Du Lac, WI 54935-4560 | 2020-03-31 |
| 1235766718 | Emily Jean Thiel | Dietitian, Registered | 430 E Division St, Fond Du Lac, WI 54935-4560 | 2020-03-25 |
| 1326674136 | Alexandria Lynn Hefter | Nurse Practitioner | 430 E Division St, Fond Du Lac, WI 54935-4560 | 2020-03-13 |
| 1952933046 | Gina Paveglio | Registered Nurse | 430 E Division St, Surgery Dept, Fond Du Lac, WI 54935 | 2020-02-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609482249 | Keziah Sherri Love | Counselor | W390 Wi-23, Fond Du Lac, WI 54935 | 2020-09-18 |
| 1891341988 | Cynthia Louise Singleton | Nurse Practitioner | 16 E 13th St., Fond Du Lac, WI 54935 | 2019-08-14 |
| 1083183297 | Elena Alexandra Giese | Nurse Practitioner | 430 E. Division St, Fond Du Lac, WI 54935 | 2018-11-16 |
| 1669963740 | Elizabeth Anne Machi | Student in an Organized Health Care Education/Training Program | 885 Western Ave Ste 300, Fond Du Lac, WI 54935 | 2018-05-23 |
| 1184150021 | Jordan Moehn | Specialist/Technologist | 633 Prairie Pkwy, Fond Du Lac, WI 54935 | 2017-05-11 |
| 1467856336 | Chuentao Ho | Specialist/Technologist | 45 South National Ave., Fond Du Lac, WI 54935 | 2014-10-21 |
| 1437587961 | Paula Seeley | Nurse Practitioner | 63 West Pioneer Rd, Fond Du Lac, WI 54935 | 2013-10-18 |
| 1144516030 | Bonnie Kay Mallon | Registered Nurse | 118 E 9th St, Fond Du Lac, WI 54935 | 2011-06-20 |
| 1770885600 | Holly Shepard | Counselor | 23 W Scott St., Fond Du Lac, WI 54935 | 2010-11-29 |
| 1437479110 | Ruth Marie Bohn | Occupational Therapy Assistant | 244 North Macy Street, Fond Du Lac, WI 54935 | 2010-06-04 |
| Find all providers in zip 54935 | ||||
| Taxonomy Code | 207ZP0102X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pathology |
| Specialization | Anatomic Pathology & Clinical Pathology |
| A pathologist deals with the causes and nature of disease and contributes to diagnosis, prognosis and treatment through knowledge gained by the laboratory application of the biologic, chemical and physical sciences. A pathologist uses information gathered from the microscopic examination of tissue specimens, cells and body fluids, and from clinical laboratory tests on body fluids and secretions for the diagnosis, exclusion and monitoring of disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added, 7/1/2009: definition reformatted] Additional Resources: American Board of Pathology, 2007. http://www.abpath.org/ This taxonomy code identifies the combined anatomic pathology & clinical pathology route. Board certification for Medical Doctors (MDs) is provided by the American Board of Pathology. To acknowledge the diverse activities in the practice of pathology and to accommodate the interests of individuals wanting to enter the field, the ABP offers primary certification through the following three routes: combined anatomic pathology and clinical pathology, anatomic pathology only and clinical pathology only. Primary certification in anatomic pathology or clinical pathology may be combined with some of the subspecialty certifications. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154494409 | Nidhi Kumar | Pathology | 430 E Division St, Fond Du Lac, WI 54935-4560 | 2006-11-16 |
| 1447337340 | Jonathan Gedye | Pathology | 430 E Division St, Fond Du Lac, WI 54935-4560 | 2006-11-01 |
| 1750466835 | Joan Louise Mueller | Pathology | 430 E Division St, St. Agnes Hospital Pathology Dept, Fond Du Lac, WI 54935-4560 | 2006-10-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992316533 | Andrii Puzyrenko | Pathology | 9200 W Wisconsin Ave Ste L83, Milwaukee, WI 53226-3522 | 2020-08-16 |
| 1487040127 | Michelle Stoffel | Pathology | Uw Hospital and Clinics, 600 Highland Ave, Madison, WI 53792 | 2015-04-09 |
| 1447694328 | Patrick Stephen Rush | Pathology | 600 Highland Ave. H4/831, Uw Hospital and Clinics, Madison, WI 53792 | 2013-04-23 |
| 1346501756 | James Murray Angevine | Pathology | 602 Mineral Pt Road, Apt 214, Madison, WI 53705-4577 | 2012-06-01 |
| 1023314549 | Stephen Lee Mcclellan | Pathology | N4656 Lakeshore Dr, Kewaunee, WI 54216-9794 | 2011-01-31 |
| 1922231414 | Darrell Peter Skarphol | Pathology | 2480 Edgewood Ct, Green Bay, WI 54302-4813 | 2009-08-31 |
| 1518110147 | Werner Adam Reis | Pathology | 839 N Jefferson St Ste 300, Milwaukee, WI 53202-3744 | 2008-10-28 |
| 1598927444 | Leela C Thachenkary | Pathology | 7107-49th Ave, Kenosha, WI 53142 | 2008-07-01 |
| 1326211384 | Scott James Kantola | Pathology | 2800 Westhill Dr Ste 208, Wausau, WI 54401-3770 | 2008-04-10 |
| 1437355997 | Monica Goswami | Pathology | 10472 W Montana Ave, # 215, West Allis, WI 53227-3263 | 2007-06-22 |
| Find all providers with the same taxonomy | ||||
| City | FOND DU LAC |
| Zip Code | 54935 |
Please comment or provide details below to improve the information on FOND DU LAC PATHOLOGY CONSULTANTS.
| 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.