MADISON MARIE WISNESKI (NPI# 1639715873) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639715873 |
| Entity Type | Individual |
| Full Name | MADISON MARIE WISNESKI |
| Credential | PA-C |
| Practice Address |
1465 E Parkdale Ave Manistee MI 49660-9709 |
| Practice Telephone | 2319381000 |
| Mailing Telephone | 2313981000 |
| Enumeration Date | 2019-11-22 |
| Last Update Date | 2020-10-31 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1465 E PARKDALE AVE |
| City | MANISTEE |
| State | MI |
| Zip Code | 49660-9709 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598709412 | John Raymond Md PC | Radiology | 1465 E Parkdale Ave, Manistee, MI 49660-9709 | 2006-06-15 |
| 1922621762 | Lisa Marie Shoemaker | Nurse Practitioner | 1465 E Parkdale Ave, Manistee, MI 49660-9709 | 2020-05-27 |
| 1053874792 | Jesse Leah Keson | Nurse Practitioner | 1465 E Parkdale Ave, Manistee, MI 49660-9709 | 2019-04-10 |
| 1477030476 | Ecs Lakeshore PC | Anesthesiology | 1465 E Parkdale Ave, Manistee, MI 49660-9709 | 2018-07-23 |
| 1265934673 | Sally Elizabeth Somsel | Physical Therapist | 1465 E Parkdale Ave, Manistee, MI 49660 | 2018-03-01 |
| 1871094466 | Lauren Elizabeth Welsh | Physical Therapist | 1465 E Parkdale Ave, Manistee, MI 49660-9709 | 2018-02-28 |
| 1518468669 | Annette Sue Hart | Occupational Therapist | 1465 E Parkdale Ave, Manistee, MI 49660-9709 | 2018-02-23 |
| 1861993917 | Kristen King | Occupational Therapist | 1465 E Parkdale Ave, Manistee, MI 49660-9709 | 2018-02-23 |
| 1043731979 | Benjamin S Long | Emergency Medicine | 1465 E Parkdale Ave, Manistee, MI 49660-9709 | 2017-06-30 |
| 1598139511 | Northern Lights Radiology P C | Radiology | 1465 E Parkdale Ave, Manistee, MI 49660-9709 | 2015-11-16 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083192306 | Margaret R Batzer | Acupuncturist | 352 1st St, Manistee, MI 49660 | 2018-07-30 |
| 1821590373 | Esther Sigurdardottir | Physical Therapist | 1465 E. Parkdale Av, Manistee, MI 49660 | 2018-03-01 |
| 1104328657 | Bryan Keith Kidd | Physical Therapist | 1465 Parkdale Avenue, Manistee, MI 49660 | 2018-03-01 |
| 1790153799 | Deborah Ann Brandt | Registered Nurse | 318 River Street, Friends Who Care, Manistee, MI 49660 | 2015-09-08 |
| 1265811624 | Joyce Eileen Copeland | Assisted Living Facility | 3644 Chippewa Hwy, Manistee, MI 49660 | 2015-05-19 |
| 1275927931 | Usv Optical Inc. | Eyewear Supplier (Equipment, not the service) | 16 Caberfae Hwy, Manistee, MI 49660 | 2015-03-20 |
| 1518244912 | Mara Lane Mckinley | Nurse Practitioner | 1465 E. Parkdale Ave3., Manistee, MICHIGAN 49660 | 2011-11-14 |
| 1477749406 | Catherine Imelda Oertel | Social Worker | 2198 Us 31 South, Manistee, MI 49660 | 2007-09-24 |
| 1811109051 | Goodwill Optical Inc | Optometrist | 282 12th St, Manistee, MI 49660 | 2007-05-03 |
| 1144364381 | Layne Christopher Godzina | Dentist | 422 First Street, Manistee, MI 49660 | 2007-02-19 |
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| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245326628 | Trista M Paone | Physician Assistant | 300 Care Center Dr, Manistee, MI 49660-2206 | 2006-10-05 |
| 1558830042 | Haley Lynn Gerstheimer | Physician Assistant | 2198 Us 31 S, Manistee, MI 49660-9618 | 2018-11-14 |
| 1023451887 | Kristin J Watson | Physician Assistant | 2198 Us 31 S, Manistee, MI 49660-9618 | 2013-04-11 |
| 1780979971 | Marisa Gardner | Physician Assistant | 1293 E Parkdale Ave, Manistee, MI 49660 | 2011-06-15 |
| 1760700363 | Katie J Dye | Physician Assistant | 1400 E Parkdale Ave, Suite 3, Manistee, MI 49660-9776 | 2010-05-07 |
| 1720092943 | James W Vanfossen | Physician Assistant | 1465 E Parkdale Ave, Manistee, MI 49660-9709 | 2006-07-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164022331 | Anna Lynn Shrift | Physician Assistant | 849 Black Hill Ln, Traverse City, MI 49696-8674 | 2020-10-27 |
| 1972102556 | Aaron Buckley | Physician Assistant | 567 Saint Louis St, Ferndale, MI 48220-2436 | 2020-10-23 |
| 1013516194 | Rebecca Mary Cronin | Physician Assistant | 4311 Kingsbrook Dr, Kalamazoo, MI 49006-3909 | 2020-10-20 |
| 1801495023 | Keriah Khairi Abd | Physician Assistant | 42836 Bloomingdale Dr, Sterling Heights, MI 48314-2843 | 2020-10-19 |
| 1154929016 | Angela Varghese | Physician Assistant | 461 Tanner Dr, Troy, MI 48085-4714 | 2020-10-13 |
| 1861090730 | Maloree Blayke Perkins | Physician Assistant | 20717 Coventry St, Clinton Twp, MI 48035-1603 | 2020-10-13 |
| 1801494000 | Sarah Puchala Lucero | Physician Assistant | 25614 Wilson Dr, Dearborn Heights, MI 48127-3427 | 2020-10-12 |
| 1871191007 | Julia Marie Tucker | Physician Assistant | 12250 E Ridge Dr, Bruce Twp, MI 48065-2011 | 2020-10-10 |
| 1164020301 | Sara Whitneyann Vandeman | Physician Assistant | 7901 S 12th St Ste 101, Portage, MI 49024-3831 | 2020-10-10 |
| 1831796267 | Jowharh Zindani | Physician Assistant | 12020 Mitchell St, Hamtramck, MI 48212-2722 | 2020-10-08 |
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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.