CHARLES L BOURSIER (NPI# 1619950888) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619950888 |
| Entity Type | Individual |
| Full Name | CHARLES L BOURSIER |
| Credential | MD |
| Practice Address |
2817 New Pinery Rd. Divine Savior Healthcare Inc Portage WI 53901-0387 |
| Practice Telephone | 6087424131 |
| Practice Fax Number | 6087455173 |
| Mailing Telephone | 6087424131 |
| Mailing Fax Number | 6087455173 |
| Enumeration Date | 2005-11-22 |
| Last Update Date | 2012-01-30 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207P00000X | Emergency Medicine | 43764020 | WI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 34133600 | 05 |
| Street Address |
2817 NEW PINERY RD. DIVINE SAVIOR HEALTHCARE INC |
| City | PORTAGE |
| State | WI |
| Zip Code | 53901-0387 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669472858 | James J Foskett | Orthopaedic Surgery | 2817 New Pinery Rd., Divine Savior Heathcare, Inc., Portage, WI 53901-0387 | 2005-07-28 |
| 1013171727 | Kelly Rae Toijala | Physician Assistant | 2817 New Pinery Rd., Divine Savior Healthcare, Inc, Portage, WI 53901-0387 | 2008-07-11 |
| 1376527002 | Susan H Kreckman | Family Medicine | 2817 New Pinery Rd., Divine Savior Healthcare, Inc., Portage, WI 53901-0387 | 2005-12-06 |
| 1538142765 | Kenneth K Oh | Physical Medicine & Rehabilitation | 2817 New Pinery Rd., Divine Savior Healthcare Inc, Portage, WI 53901-0387 | 2005-11-22 |
| 1336122506 | Darcy L Steinhorst | Physician Assistant | 2817 New Pinery Rd., Divine Savior Healthcare Inc, Portage, WI 53901-0387 | 2005-11-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740710748 | Robert James Corliss | Internal Medicine | St. Vincent Fmc, 140east Cook St., Portage, WI 53901 | 2017-06-13 |
| 1639328867 | Casey Jo Ambort | Speech-Language Pathologist | 626 East Slifer St, Portage, WI 53901 | 2008-09-11 |
| 1871767400 | Planned Parenthood of Wi, Inc | Non-Pharmacy Dispensing Site | 132 W. Cook St., Portage, WI 53901 | 2008-04-15 |
| 1881872158 | Marta Jean Jindra | Physical Therapist | 626 E Slifer Street, Portage, WI 53901 | 2008-02-08 |
| 1699953976 | Lana Marie Edwards | Speech-Language Pathologist | 626 East Slifer Street, Portage, WI 53901 | 2008-02-08 |
| 1134314552 | Kristina Hellenbrand | Physical Therapist | 2639 New Pinery Road, Suite 2, Portage, WI 53901 | 2007-09-10 |
| 1689727810 | Gregory Allan Bindl | Chiropractor | 2121new Pinery Rd, Portage, WI 53901 | 2007-01-19 |
| 1720149156 | Timothy J Rosin Dds Sc | Dentist | 2570 New Pinery Rd, Portage, WI 53901 | 2006-12-12 |
| 1710083779 | Currani Seubert Dental Office LLC | Dentist | 260 W Cook St, Portage, WI 53901 | 2006-09-16 |
| 1225090525 | University of Wisconsin Medical Foundation Inc | Durable Medical Equipment & Medical Supplies | 2977 Cty Hwy Cx, Portage, WI 53901 | 2006-04-04 |
| Find all providers in zip 53901 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598185373 | Medexpress Urgent Care, PC - Michigan | Emergency Medicine | 6929 S Westnedge Ave, Portage, MI 49002-3550 | 2014-04-21 |
| 1902232473 | David F. Scullion | Emergency Medicine | 480 West Rd., Portage, ME 04768 | 2013-09-17 |
| 1174506307 | James T Gariti Sr. | Emergency Medicine | 2817 New Pinery Rd, Divine Savior Healthcare Inc, Portage, WI 53901-9257 | 2005-11-22 |
| 1720074701 | Muhammad Q. Choudry | Emergency Medicine | 3630 Willowcreek Rd, Portage, IN 46368-5075 | 2005-09-23 |
| 1639457740 | Robert S Redwood | Emergency Medicine | 2817 New Pinery Rd, Portage, WI 53901-9240 | 2011-07-25 |
| 1083901342 | Francesca Rose Mcqueen | Emergency Medicine | 7901 Angling Rd, Portage, MI 49024-0714 | 2011-07-06 |
| 1912131699 | Marc D Biedermann | Emergency Medicine | 2817 New Pinery Rd, Portage, WI 53901 | 2009-05-08 |
| 1003066143 | John P Beavers | Emergency Medicine | 5717 Oakland Dr, Portage, MI 49024-1116 | 2008-09-25 |
| 1336315324 | Jennifer Marie Bahr | Emergency Medicine | 2817 New Pinery Rd, Divine Savior Healthcare, Inc., Portage, WI 53901-9240 | 2008-04-30 |
| 1649213554 | Michael M Bermudez | Emergency Medicine | 3630 Willowcreek Rd, Portage, IN 46368-5075 | 2006-06-14 |
| Find all providers in PORTAGE | ||||
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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.