DR. DEZERAY CLARE MATOTT (NPI# 1649655952) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649655952 |
| Entity Type | Individual |
| Full Name | DR. DEZERAY CLARE MATOTT |
| Other Name | MS. DEZERAY CLARE TOMESH |
| Credential | NP |
| Practice Address |
12961 27th Ave Chippewa Falls WI 54729-5699 |
| Practice Telephone | 7157383700 |
| Mailing Telephone | 7157383700 |
| Enumeration Date | 2015-07-28 |
| Last Update Date | 2015-07-28 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
6503-33 | WI | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
12961 27TH AVE |
| City | CHIPPEWA FALLS |
| State | WI |
| Zip Code | 54729-5699 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619942257 | Billie J. Hague | Nurse Practitioner | 12961 27th Ave, Chippewa Falls, WI 54729-5699 | 2006-02-17 |
| 1831737048 | Janis Cekan | Nurse Practitioner | 12961 27th Ave, Chippewa Falls, WI 54729-5699 | 2019-12-18 |
| 1023452943 | Family Health Center of Marshfield, Inc. | Durable Medical Equipment & Medical Supplies | 12961 27th Ave, Chippewa Falls, WI 54729-5699 | 2013-04-22 |
| 1235461872 | Sharon A. Koenig | Nurse Practitioner | 12961 27th Ave, Chippewa Falls, WI 54729-5699 | 2010-02-08 |
| 1376789040 | Marshfield Clinic, Inc. | Durable Medical Equipment & Medical Supplies | 12961 27th Ave, Chippewa Falls, WI 54729-5699 | 2008-12-30 |
| 1033363262 | Marshfield Clinic | Pharmacy | 12961 27th Ave, Chippewa Falls, WI 54729 | 2008-11-14 |
| 1417042797 | Chau T Nguyen | Physician Assistant | 12961 27th Ave, Chippewa Falls, WI 54729-5699 | 2006-10-04 |
| 1306931670 | Jeffrey Shepich | Family Medicine | 12961 27th Ave, Chippewa Falls, WI 54729-5699 | 2006-10-04 |
| 1306947908 | Thomas D Sandager | Family Medicine | 12961 27th Ave, Chippewa Falls, WI 54729-5699 | 2006-09-26 |
| 1063522134 | David L. Brucher | Physician Assistant | 12961 27th Ave, Chippewa Falls, WI 54729-5699 | 2006-08-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669963468 | Stephanie Ann Mclaughlin | Counselor | 345 Frenette Dr Ste 3, Chippewa Falls, WI 54729 | 2018-05-29 |
| 1841613148 | Terri Roberts | Nurse Practitioner | 2661 Cty Hwy I, Chippewa Falls, WI 54729 | 2014-01-23 |
| 1487928792 | Angela Marie Halbert | In Home Supportive Care | 5545 165th St, Chippewa Falls, WI 54729 | 2012-03-05 |
| 1679869739 | Furniture Loft, Inc. | Durable Medical Equipment & Medical Supplies | 1849 County Highway Oo, Chippewa Falls, WI 54729 | 2011-06-27 |
| 1184917825 | Joshua Paul Finn | Chiropractor | 17 East Central Street, Chippewa Falls, WI 54729 | 2011-05-26 |
| 1346540978 | St. Joseph's Hospital | Rehabilitation Hospital | 2661 County Road I, Chippewa Falls, WI 54729 | 2010-10-29 |
| 1770819773 | Chippewa Clinic Pharmacy | Pharmacy | 2509 County Hwy I, Chippewa Falls, WI 54729 | 2009-10-26 |
| 1689811853 | Clark Family Dental Inc | Dentist | 777 Park Avenue, Chippewa Falls, WI 54729 | 2009-01-09 |
| 1295995660 | Kelly S Abraham | Licensed Practical Nurse | 400 Pumphouse Rd, Apt #26, Chippewa Falls, WI 54729 | 2008-06-10 |
| 1225296700 | Wellington Hervey Davis Jr. | Registered Nurse | 721 Buttenhoff Rd, Chippewa Falls, WI 54729 | 2008-05-30 |
| Find all providers in zip 54729 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619942257 | Billie J. Hague | Nurse Practitioner | 12961 27th Ave, Chippewa Falls, WI 54729-5699 | 2006-02-17 |
| 1831737048 | Janis Cekan | Nurse Practitioner | 12961 27th Ave, Chippewa Falls, WI 54729-5699 | 2019-12-18 |
| 1023668753 | Carla Griggs | Nurse Practitioner | 2509 County Highway I Ste 500, Chippewa Falls, WI 54729-2786 | 2019-09-15 |
| 1295213445 | Lauren Anne Hartman | Nurse Practitioner | 2509 County Highway I, Chippewa Falls, WI 54729-2785 | 2018-07-31 |
| 1063923993 | Mh Health Care Services, PC | Nurse Practitioner | 234 Cashman Dr, Chippewa Falls, WI 54729-3543 | 2017-10-18 |
| 1972923530 | Katherine Stolp Keisler | Nurse Practitioner | 2829 County Highway I, Suite 2, Chippewa Falls, WI 54729-2652 | 2014-04-22 |
| 1710142369 | Elizabeth Anne Tillotson | Nurse Practitioner | 475 Chippewa Mall Dr, Chippewa Falls, WI 54729-5034 | 2008-07-23 |
| 1861546186 | Kristi Margaret Burdick | Nurse Practitioner | 2509 County Highway I, Chippewa Falls, WI 54729 | 2007-01-23 |
| 1245245778 | Susan Raquel Eckwright | Nurse Practitioner | 2509 County Highway I, Chippewa Falls, WI 54729-2785 | 2006-07-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982203857 | Tiera Manuel | Nurse Practitioner | 3956 N 28th St, Milwaukee, WI 53216-2637 | 2020-10-22 |
| 1801494778 | Tajana Jovicic | Nurse Practitioner | 3157 S 66th St, Milwaukee, WI 53219-4105 | 2020-10-13 |
| 1497352090 | Carlotta Williams | Nurse Practitioner | 1205 Juniper Ln, Oconomowoc, WI 53066-3100 | 2020-10-06 |
| 1932706611 | Rachel Sullivan | Nurse Practitioner | 304 E Northlawn Dr, Cottage Grove, WI 53527-8917 | 2020-10-05 |
| 1649877663 | Kirk O'hanison | Nurse Practitioner | 1020 Oconomowoc Pkwy Unit B, Oconomowoc, WI 53066-4616 | 2020-10-02 |
| 1780291401 | Carlie Dell | Nurse Practitioner | 1636 Industrial Pkwy N, Marinette, WI 54143-3703 | 2020-09-27 |
| 1093320459 | Tyronda T Gray | Nurse Practitioner | 5833 N 117th St, Milwaukee, WI 53225-2207 | 2020-09-12 |
| 1629683065 | Yia Lor | Nurse Practitioner | 3750 Summerset Way Apt 1, Oshkosh, WI 54901-0501 | 2020-09-11 |
| 1245844364 | Asia Ann Gomez | Nurse Practitioner | 2816 E Allison Ave, Cudahy, WI 53110-2541 | 2020-09-04 |
| 1861005837 | Clair Roser Rivera | Nurse Practitioner | 3734 W Ohio Ave, Milwaukee, WI 53215-4047 | 2020-08-28 |
| Find all providers with the same taxonomy | ||||
| City | CHIPPEWA FALLS |
| Zip Code | 54729 |
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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.