MATTHEW THOMAS CLANCY (NPI# 1639180961) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639180961 |
| Entity Type | Individual |
| Full Name | MATTHEW THOMAS CLANCY |
| Credential | M.D. |
| Practice Address |
333 Pine Ridge Blvd Suite 317 Wausau WI 54401-4102 |
| Mailing Address |
8001 Woodbine Ln Wausau WI 54401-8467 |
| Practice Telephone | 7158472837 |
| Practice Fax Number | 7158472614 |
| Mailing Telephone | 7153556031 |
| Mailing Fax Number | 7158472614 |
| Enumeration Date | 2006-08-11 |
| Last Update Date | 2017-04-07 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2083P0011X |
Preventive Medicine Specialization: Undersea and Hyperbaric Medicine |
41861-020 | WI | Allopathic & Osteopathic Physicians |
| Street Address |
333 PINE RIDGE BLVD SUITE 317 |
| City | WAUSAU |
| State | WI |
| Zip Code | 54401-4102 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558363986 | Aspirus Wausau Hospital, Inc | General Acute Care Hospital | 333 Pine Ridge Blvd, Wausau, WI 54401-4120 | 2005-08-15 |
| 1902415789 | John Hupp II | Registered Nurse | 333 Pine Ridge Blvd, Wausau, WI 54401-4102 | 2020-07-28 |
| 1720600240 | Jennifer Scharenbrock | Physical Therapist | 333 Pine Ridge Blvd, Wausau, WI 54401-4102 | 2020-05-07 |
| 1467009282 | Anson Mcquigg | Nurse Anesthetist, Certified Registered | 333 Pine Ridge Blvd, Wausau, WI 54401-4102 | 2019-08-26 |
| 1447807086 | Kelly Jonathon Douck | Nurse Anesthetist, Certified Registered | 333 Pine Ridge Blvd, Wausau, WI 54401-4102 | 2019-08-19 |
| 1699329102 | Madeline Erickson | Occupational Therapist | 333 Pine Ridge Blvd, Wausau, WI 54401-4187 | 2019-08-01 |
| 1194384198 | Emily Morgan Meyer | Occupational Therapist | 333 Pine Ridge Blvd, Wausau, WI 54401-4102 | 2019-06-12 |
| 1659937738 | Breanna Zajichek | Physician Assistant | 333 Pine Ridge Blvd, Wausau, WI 54401-4102 | 2019-05-14 |
| 1336703677 | Sophia Frances Andera-cato | Physician Assistant | 333 Pine Ridge Blvd, Wausau, WI 54401-4187 | 2019-04-23 |
| 1073096681 | Beth Brinkman | Occupational Therapist | 333 Pine Ridge Blvd, Wausau, WI 54401-4102 | 2018-09-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164031464 | Central Wisconsin Endodontic Specialists LLC | Dentist | 2606 Stewart Avenue, #102, Wausau, WI 54401 | 2020-07-23 |
| 1376161976 | Family Foot and Ankle Clinic LLC | Podiatrist | 1901 Westwood Boulevard, Wausau, WI 54401 | 2020-07-09 |
| 1336701895 | Amy Kluetz | Counselor | 3000 Westhill Drive, Suite 100, Wausau, WI 54401 | 2019-07-05 |
| 1437640877 | Joseph T Fitz | Student in an Organized Health Care Education/Training Program | Aspirus Wausau Family Medicine, 425 Wind Ridge Drive, Wausau, WI 54401 | 2018-05-22 |
| 1699293241 | Amanda Nedd | Dietitian, Registered | 425 Pine Ridge Boulevard Suite 220 C, Wausau, WI 54401 | 2017-09-05 |
| 1396287447 | Dee Cha | Nurse Anesthetist, Certified Registered | 4851 Rachel Ln Apt 5, Wausau, WI 54401 | 2016-11-07 |
| 1013389618 | Grace Lutheran Foundation Inc | Skilled Nursing Facility | 2727 Plaza Dr., Wausau, WI 54401 | 2015-10-22 |
| 1881091163 | Judy Lao | Dental Hygienist | 413 North 17th Avenue, Wausau, WI 54401 | 2014-12-02 |
| 1295012011 | Allison Waraksa | Pharmacist | 504 S. 17th Ave, Wausau, WI 54401 | 2011-11-08 |
| 1881974053 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 504 S 17th Ave, Wausau, WI 54401 | 2011-08-19 |
| Find all providers in zip 54401 | ||||
| Taxonomy Code | 2083P0011X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Preventive Medicine |
| Specialization | Undersea and Hyperbaric Medicine |
| A specialist who treats decompression illness and diving accident cases and uses hyperbaric oxygen therapy to treat such conditions as carbon monoxide poisoning, gas gangrene, non-healing wounds, tissue damage from radiation and burns and bone infections. This specialist also serves as consultant to other physicians in all aspects of hyperbaric chamber operations and assesses risks and applies appropriate standards to prevent disease and disability in divers and other persons working in altered atmospheric conditions. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Preventive Medicine, 2007. http://www.abprevmed.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Preventive Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659696029 | Hyperbaric Associates Sc | Preventive Medicine | 333 Pine Ridge Blvd, Suite 300, Wausau, WI 54401-4120 | 2010-03-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003870395 | John P Simanonok | Preventive Medicine | 2901 W Kinnickinnic River Pkwy Ste 309, Milwaukee, WI 53215-3660 | 2006-04-13 |
| 1992221840 | Healogics Specialty Physicians of Wisconsin, LLC | Preventive Medicine | 430 Wilcox St, Fort Atkinson, WI 53538-1968 | 2017-08-22 |
| 1285093104 | Kyle Justin Dubose | Preventive Medicine | 10400 75th St, Kenosha, WI 53142-7884 | 2016-02-20 |
| 1811356736 | Cory Ryan Dubose | Preventive Medicine | 2900 W Oklahoma Ave, Milwaukee, WI 53215-4330 | 2016-02-20 |
| 1316148273 | Lori L Mcallister | Preventive Medicine | 2900 W Oklahoma Ave, Milwaukee, WI 53215-4330 | 2007-05-29 |
| 1821118506 | Matthew L White | Preventive Medicine | 2900 W Oklahoma Ave, Hyperbaric Medicine & Wound Care/slmc, Milwaukee, WI 53215-4330 | 2007-03-29 |
| 1194895920 | Laurie Beth Gesell | Preventive Medicine | 2900 W Oklahoma Ave, Milwaukee, WI 53215-4330 | 2006-11-09 |
| 1376650788 | Roland P Moreno | Preventive Medicine | 2845 Greenbrier Rd, Green Bay, WI 54311-6519 | 2006-08-23 |
| 1487689451 | Gerald C Godfrey | Preventive Medicine | 2900 W Oklahoma Ave, Milwaukee, WI 53215-4330 | 2006-07-11 |
| 1164454302 | Thomas C Betka | Preventive Medicine | 2845 Greenbrier Rd, Green Bay, WI 54311-6519 | 2006-07-07 |
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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.