JOHN RAYMOND CARROLL (NPI# 1639142953) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639142953 |
| Entity Type | Individual |
| Full Name | JOHN RAYMOND CARROLL |
| Credential | M.D. |
| Practice Address |
1032 S Cesar E Chavez Dr Milwaukee WI 53204-2203 |
| Practice Telephone | 4146721353 |
| Practice Fax Number | 4146724265 |
| Mailing Telephone | 4146721353 |
| Mailing Fax Number | 4146724265 |
| Enumeration Date | 2006-02-08 |
| Last Update Date | 2011-09-09 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 31103 | WI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | DEA | BC9601407 | 01 |
| WI | AETNA | 4567737 | 01 |
| WI | 31609200 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043853658 | John Carroll | Marriage & Family Therapist | 400 W 23rd St Apt 5j, New York, NY 10011-2176 | 2019-10-26 |
| 1376852301 | John Carroll | Emergency Medicine | 2727 W Heading Ave, West Peoria, IL 61604-4981 | 2010-09-24 |
| 1417151440 | John Raymond Carroll | Student in an Organized Health Care Education/Training Program | 42 E. Laurel Rd, Udp At Umdnj-som, Dept. of Family Medicine, Rm 2100, Stratford, NJ 08084 | 2007-06-13 |
| 1396869210 | John Francis Carroll | Pediatrics | 108 Canal Walk Blvd, Somerset, NJ 08873-7277 | 2007-03-17 |
| 1508946054 | John T Carroll | Podiatrist | 455 Boston Post Rd Ste 8, Old Saybrook, CT 06475-1554 | 2006-10-17 |
| 1457379042 | John Thomas Carroll | Obstetrics & Gynecology | 503 Thornhill Dr, Carol Stream, IL 60188-2780 | 2006-07-18 |
| 1952340069 | John L Carroll | Dentist | 1020 5th St Se, Winter Haven, FL 33880-4210 | 2006-06-05 |
| 1063468932 | John Anthony Carroll | Internal Medicine | 8328 E Hartford Dr, Scottsdale, AZ 85255-6520 | 2006-05-25 |
| 1508811860 | John D Carroll | Internal Medicine | 10689 Hardin Valley Rd, Knoxville, TN 37932-1504 | 2006-05-24 |
| 1376511717 | John M Carroll | Internal Medicine | 390 Pleasant St, Malden, MA 02148-8114 | 2006-03-10 |
| Street Address |
1032 S CESAR E CHAVEZ DR |
| City | MILWAUKEE |
| State | WI |
| Zip Code | 53204-2203 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477558104 | Thomas M Bachhuber | Family Medicine | 1032 S Cesar E Chavez Dr, Milwaukee, WI 53204-2203 | 2005-06-17 |
| 1225644651 | Ellen Leitner | Social Worker | 1032 S Cesar E Chavez Dr, Milwaukee, WI 53204-2203 | 2020-09-21 |
| 1770195588 | Kristen Silverman | Dietitian, Registered | 1032 S Cesar E Chavez Dr, Milwaukee, WI 53204-2203 | 2020-08-21 |
| 1598391724 | Carla Freitas De Melo | Nurse Practitioner | 1032 S Cesar E Chavez Dr, Milwaukee, WI 53204-2203 | 2020-03-19 |
| 1588216733 | Vanessa Rosas | Counselor | 1032 S Cesar E Chavez Dr, Milwaukee, WI 53204-2203 | 2019-07-09 |
| 1821650102 | Suelhem A Grochowski | Nurse Practitioner | 1032 S Cesar E Chavez Dr, Milwaukee, WI 53204-2203 | 2019-07-08 |
| 1114589728 | Rachel Eucharistia Claudio | Dental Hygienist | 1032 S Cesar E Chavez Dr, Milwaukee, WI 53204-2203 | 2019-07-03 |
| 1073099867 | Madeline Kay Cernuda | Physician Assistant | 1032 S Cesar E Chavez Dr, Milwaukee, WI 53204-2203 | 2018-07-14 |
| 1437677473 | Jill Litkowski | Advanced Practice Midwife | 1032 S Cesar E Chavez Dr, Milwaukee, WI 53204-2203 | 2017-08-30 |
| 1114441540 | Angela Kathryn Golon | Registered Nurse | 1032 S Cesar E Chavez Dr, Milwaukee, WI 53204-2203 | 2017-07-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528423290 | Blue Ribbon Healthcare LLC | Health Maintenance Organization | 1743 South1st Street, Milwaukee, WI 53204 | 2015-12-23 |
| 1215336599 | Marsha Vann | Counselor | 1028 N 9th St, Milwaukee, WI 53204 | 2014-08-22 |
| 1891109260 | Melissa Bendever | Counselor | 1111 South 6th Street, Milwaukee, WI 53204 | 2014-06-13 |
| 1942585823 | Theresa Marie Hintze | Counselor | 600 W Virginia Atlas Ste 203, Milwaukee, WI 53204 | 2011-10-11 |
| 1922395151 | Palmas & Ram Rudra LLC | Chiropractor | 1247 S. Cesar E. Chaves Drive, Milwaukee, WI 53204 | 2011-07-08 |
| 1225355183 | Victoria A White | Family Medicine | 16th Street Community Health Center, 1032 S Cesar E. Chavez Drive, Milwaukee, WI 53204 | 2010-04-30 |
| 1174850499 | Dnt Associates Inc. | Dentist | 710 W. Historic Mitchell St., Mitchell Street Dental, Milwaukee, WI 53204 | 2009-11-06 |
| 1851559124 | Michael L Kitzinger | Social Worker | 1201 W Historic Mitchell St, Milwaukee, WI 53204 | 2008-05-23 |
| 1083778781 | Douglas Ralph Higbie | Psychologist | 634 W Mitchell St, Milwaukee, WI 53204 | 2006-12-20 |
| 1013019413 | Romeo C Lo Md | Internal Medicine | 1672 S 9th St, 2nd Floor, Milwaukee, WI 53204 | 2006-09-05 |
| Find all providers in zip 53204 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, 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 Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730679804 | Vicki Milroy | Family Medicine | 2778 S 35th St Ste 102, Milwaukee, WI 53215-3578 | 2018-05-15 |
| 1376050450 | Independent Physicians of Wisconsin, LLC | Family Medicine | 5233 S 27th St, Milwaukee, WI 53221-3764 | 2018-01-10 |
| 1427565548 | Independent Physicians of Wisconsin, LLC | Family Medicine | 3201 S 16th St Ste 2020, Milwaukee, WI 53215-4532 | 2018-01-10 |
| 1962932970 | Mary Kuder | Family Medicine | 176 N Broadway, Milwaukee, WI 53202-6015 | 2017-06-13 |
| 1386178804 | Dane A Olsen | Family Medicine | 801 W Kinnickinnic River Pkwy., Suite 250, Milwaukee, WI 53215 | 2017-04-12 |
| 1598296212 | Leslie J Rabaut | Family Medicine | 2801 W Kk River Pkwy Ste 250, Milwaukee, WI 53215-3678 | 2017-03-23 |
| 1871975920 | Independent Physicians of Wisconsin, LLC | Family Medicine | 5434 W Capitol Dr Ste 3, Milwaukee, WI 53216-2298 | 2015-06-25 |
| 1952717928 | Mobile Medical Clinic, Inc | Family Medicine | 2418 W Edgerton Ave, Milwaukee, WI 53221-3412 | 2014-07-10 |
| 1437572831 | Pathfinder Medical Group | Family Medicine | 216 Milwaukee St, Suite 2d, Milwaukee, WI 53202 | 2014-01-22 |
| 1376897413 | Sandra Kathleen Mahkorn | Family Medicine | 3050 S Superior St, Milwaukee, WI 53207-3064 | 2012-10-26 |
| Find all providers in MILWAUKEE | ||||
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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.