GREEN BAY CARDIOTHORACIC & VASCULAR LLC (NPI# 1659412401) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1659412401 |
Entity Type | Organization |
Organization Name | GREEN BAY CARDIOTHORACIC & VASCULAR LLC |
Practice Address |
720 S Van Buren St Suite 303 Green Bay WI 54301-3538 |
Mailing Address |
720 So Van Buren St Suite 303 Green Bay WI 54301 |
Practice Telephone | 9204339621 |
Practice Fax Number | 9204330565 |
Mailing Telephone | 9204339621 |
Mailing Fax Number | 9204330565 |
Enumeration Date | 2007-02-12 |
Last Update Date | 2011-12-14 |
Authorized Official Name | STEVEN J GERNDT (OWNER) |
Authorized Official Telephone | 9204339621 |
Authorized Official Credential | MD |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
WI | RAILROAD MEDICARE | CG7604 | 01 |
WI | 32897600 | 05 |
Street Address |
720 S VAN BUREN ST SUITE 303 |
City | GREEN BAY |
State | WI |
Zip Code | 54301-3538 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1164424818 | Wen Tjoen Yap | Specialist | 720 S Van Buren St, Suite 301, Green Bay, WI 54301-3538 | 2005-08-12 |
1336796002 | Erin R Grant | Physician Assistant | 720 S Van Buren St, Green Bay, WI 54301-3538 | 2019-08-19 |
1871011569 | Molly Beth Hohol | Midwife | 720 S Van Buren St, Green Bay, WI 54301-3538 | 2017-09-02 |
1194180638 | Baycare Clinic, LLP | Physician Assistant | 720 S Van Buren St, 202, Green Bay, WI 54301-3538 | 2015-12-29 |
1225419120 | Jaimee M Larson | Physician Assistant | 720 S Van Buren St, Suite 104, Green Bay, WI 54301-3534 | 2015-06-16 |
1003210725 | Kristen Kay Lampe | Nurse Practitioner | 720 S Van Buren St, Suite 201, Green Bay, WI 54301-3538 | 2014-10-09 |
1447567094 | Sarah J Schneider | Nurse Practitioner | 720 S Van Buren St, Suite 301, Green Bay, WI 54301-3538 | 2010-09-02 |
1568781441 | Scott M Griep | Physician Assistant | 720 S Van Buren St, Green Bay, WI 54301-3538 | 2010-05-18 |
1295925824 | Ivy E Leasum | Nurse Practitioner | 720 S Van Buren St, Suite 301, Green Bay, WI 54301-3538 | 2007-07-30 |
1609085612 | Michael Charles Mcmanus | Urology | 720 S Van Buren St, Ste 301, Green Bay, WI 54301-3538 | 2007-05-22 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1386102465 | Parc Village Dental, LLC | Dentist | 2805 Libal Street, Suite A, Green Bay, WI 54301 | 2019-03-07 |
1598229478 | Shaina Marie Conner | Registered Nurse | 835 S Vanburen St, Green Bay, WI 54301 | 2019-01-25 |
1093298960 | Brown County | Case Management | 111 N. Jefferson Street, Green Bay, WI 54301 | 2018-09-07 |
1639609928 | Frontline Healthcare LLC | Specialist/Technologist, Other | 2221 S. Webster Ave. Suite 270, Greenbay, WI 54301 | 2017-06-19 |
1992242606 | Charmaine Rimple | Counselor | 526 South Monroe Avenue, Green Bay, WI 54301 | 2017-01-20 |
1962944819 | Rebecca Lucille Reinbold | Registered Nurse | 917 Catherine Street, Green Bay, WI 54301 | 2016-11-09 |
1730635061 | Melissa Kristof | Specialist/Technologist, Other | 1821 Sounth Webster Ave., Green Bay, WI 54301 | 2016-08-28 |
1255709747 | Vivian Sweetheart Bishop-cook | Counselor | 2920 South Webster Ave, Green Bay, WI 54301 | 2015-09-14 |
1881079960 | Chelsi S Weber | Registered Nurse | 2300 Riverside Dr., Ste 204, Green Bay, WI 54301 | 2015-07-30 |
1962816371 | Joelle M Hesse | Counselor | 630 Cherry St., Green Bay, WI 54301 | 2014-06-13 |
Find all providers in zip 54301 |
Taxonomy Code | 207RC0000X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Internal Medicine |
Specialization | Cardiovascular Disease |
An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1396824074 | Cardiology Associates of Green Bay, Ltd | Internal Medicine | 744 S. Webster Ave, 2nd Floor, Green Bay, WI 54301-3505 | 2006-11-03 |
1407828676 | Ramon Ray Gregorio Rayel | Internal Medicine | 2845 Greenbrier Rd Ste 310, Green Bay, WI 54311-6519 | 2006-02-02 |
1639157936 | Peter Fergus | Internal Medicine | 1727 Shawano Ave, Ste 201, Green Bay, WI 54303-3273 | 2006-01-06 |
1245659051 | Laura S Beacher | Internal Medicine | 744 S Webster Ave, Green Bay, WI 54301-3505 | 2014-04-09 |
1467771535 | Bellin Memorial Hospital Inc | Internal Medicine | 744 S Webster Ave, 2nd Floor, Green Bay, WI 54301-3505 | 2010-05-27 |
1174841985 | Armaan C Shaikh | Internal Medicine | 2845 Greenbrier Rd, Green Bay, WI 54311 | 2010-05-04 |
1750534533 | Bellin Memorial Hospital Inc | Internal Medicine | 744 S Webster Ave, Green Bay, WI 54301-3505 | 2008-10-24 |
1609027168 | Kendra Marsh-kates | Internal Medicine | 1821 S Webster Ave, Green Bay, WI 54301-2253 | 2008-10-02 |
1336238161 | Mohammad R. Jazayeri | Internal Medicine | 744 S Webster Ave, 2nd Floor, Green Bay, WI 54301-3505 | 2006-10-12 |
1801817432 | Francis G Wolf | Internal Medicine | 2845 Greenbrier Rd Ste 310, Green Bay, WI 54311-6519 | 2006-07-21 |
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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.