FROEDTERT & THE MEDICAL COLLEGE OF WISCONSIN COMMUNITY PHYSICIANS INC (NPI# 1669851770) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669851770 |
| Entity Type | Organization |
| Organization Name | FROEDTERT & THE MEDICAL COLLEGE OF WISCONSIN COMMUNITY PHYSICIANS INC |
| Other Organization Name | FROEDTERT PHYSICIAN PARTNERS INC |
| Practice Address |
1701 Fond Du Lac Ave Kewaskum WI 53040-9129 |
| Mailing Address |
W126n7338 Flint Dr Suite 300 Menomonee Falls WI 53051-4532 |
| Practice Telephone | 2626264616 |
| Mailing Telephone | 4147770810 |
| Mailing Fax Number | 4147777927 |
| Enumeration Date | 2015-05-21 |
| Last Update Date | 2015-05-21 |
| Authorized Official Name | CATHERINE MODE-EASTHAM (SR VICE PRESIDENT & GENERAL COUNSEL) |
| Authorized Official Telephone | 4148052994 |
| Is Organization Subpart | Y |
| Parent Organization Name | FROEDTERT & THE MEDICAL COLLEGE OF WISCONSIN COMMUNITY PHYSICIAN |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 291U00000X | Clinical Medical Laboratory | WI | Laboratories |
| Other Name | Type Code |
|---|---|
| Froedtert Physician Partners Inc | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477188100 | Froedtert & The Medical College of Wisconsin Community Physicians Inc | Non-Pharmacy Dispensing Site | 635 S 28th St, Milwaukee, WI 53215-1201 | 2020-03-03 |
| 1922641877 | Froedtert & The Medical College of Wisconsin Community Physicians Inc | Durable Medical Equipment & Medical Supplies | W234s3555 Les Paul Pkwy, Waukesha, WI 53189-8512 | 2019-10-23 |
| 1790242352 | Froedtert & The Medical College of Wisconsin Community Physicians Inc | Durable Medical Equipment & Medical Supplies | 6255 N Santa Monica Blvd, Milwaukee, WI 53217-4353 | 2019-03-01 |
| 1912437252 | Froedtert & The Medical College of Wisconsin Community Physicians Inc | Durable Medical Equipment & Medical Supplies | 11430 Port Washington Road, Mequon, WI 53092 | 2017-06-19 |
| 1154947224 | Froedtert & The Medical College of Wisconsin Community Physicians Inc | Durable Medical Equipment & Medical Supplies | 1155 N Mayfair Rd, Wauwatosa, WI 53226-3462 | 2020-06-24 |
| 1811340383 | Froedtert & The Medical College of Wisconsin Community Physicians Inc | Durable Medical Equipment & Medical Supplies | W180n8000 Town Hall Rd, Menomonee Falls, WI 53051-4002 | 2016-07-19 |
| 1265811327 | Froedtert & The Medical College of Wisconsin Community Physicians Inc | Clinical Medical Laboratory | N64w24801 Main St, Suite 109, Sussex, WI 53089-2652 | 2015-05-22 |
| 1700265865 | Froedtert & The Medical College of Wisconsin Community Physicians Inc | Clinical Medical Laboratory | 1700 W Paradise Dr, West Bend, WI 53095-9795 | 2015-05-22 |
| 1841679958 | Froedtert & The Medical College of Wisconsin Community Physicians Inc | Clinical Medical Laboratory | W225n16711 Cedar Park Ct, Jackson, WI 53037-9222 | 2015-05-21 |
| 1376922484 | Froedtert & The Medical College of Wisconsin Community Physicians Inc | Clinical Medical Laboratory | W180n8000 Town Hall Rd, Menomonee Falls, WI 53051-4002 | 2015-05-21 |
| Street Address |
1701 FOND DU LAC AVE |
| City | KEWASKUM |
| State | WI |
| Zip Code | 53040-9129 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518976919 | West Bend Clinic | Internal Medicine | 1701 Fond Du Lac Ave, Kewaskum, WI 53040-9129 | 2006-08-05 |
| 1548743586 | Jennifer Rose Nogalski | Nurse Practitioner | 1701 Fond Du Lac Ave, Kewaskum, WI 53040-9129 | 2018-09-14 |
| 1801349261 | Christina Smith | Nurse Practitioner | 1701 Fond Du Lac Ave, Kewaskum, WI 53040-9129 | 2016-08-02 |
| 1811335334 | Froedtert & The Medical College of Wisconsin Community Physicians, Inc | Durable Medical Equipment & Medical Supplies | 1701 Fond Du Lac Ave, Kewaskum, WI 53040-9129 | 2013-06-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902076698 | Craig Alan Bruesewitz | Counselor | 1421 Fond Du Lac Avenue, Kewashum, WI 53040 | 2008-03-10 |
| 1508040700 | Sara Marie Bonlender | Licensed Practical Nurse | 1841 Edgewood Road, Kewaskum, WI 53040 | 2007-12-24 |
| 1861506255 | Kewaskum Fire Department | Ambulance | 1106 Fond Du Lac Ave, Kewaskum, WI 53040 | 2006-08-19 |
| 1619219532 | Cheryl Elizabeth Colwin | Counselor | 1421 Fond Du Lac Avenue, Kewaskum, WI 53040 | 2013-03-18 |
| 1790188498 | Nicolai Gerhartz | Physician Assistant | W832 County Rd S, Kewaskum, WI 53040-1116 | 2014-10-08 |
| 1871785931 | Kewaskum School District | Speech-Language Pathologist | 1676 Reigle Dr Ste 100, Kewaskum, WI 53040-8923 | 2007-08-13 |
| 1891801957 | J Dennis Connor | Dentist | 1204 Fond Du Lac Ave, Kewaskum, WI 53040-8954 | 2006-08-22 |
| 1003941444 | J Dennis Connor Dds Sc | Dentist | 1204 Fond Du Lac Ave, Kewaskum, WI 53040-8954 | 2007-02-23 |
| 1093241002 | Nicholas Brandon Bier | Student in an Organized Health Care Education/Training Program | 311 Clinton St, Kewaskum, WI 53040-9116 | 2017-05-11 |
| 1174063424 | Lori Bersch | Massage Therapist | 336 North Ave, Kewaskum, WI 53040-9130 | 2017-03-06 |
| Find all providers in zip 53040 | ||||
| Taxonomy Code | 291U00000X |
| Grouping | Laboratories |
| Classification | Clinical Medical Laboratory |
| (1) A clinical laboratory is a facility for the biological, microbiological, serological, chemical, immunohematological, hematological, biophysical, cytological, pathological, or other examination of materials derived from the human body for the purpose of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, human beings. These examinations also include procedures to determine, measure, or otherwise describe the presence or absence of various substances or organisms in the body. Facilities only collecting or preparing specimens (or both) or only serving as a mailing service and not performing testing are not considered clinical laboratories. (2) Any facility that examines materials from the human body for purposes of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, or the assessment of, the health of human beings. Typical divisions of a clinical laboratory include hematology, cytology, bacteriology, histology, biochemistry, medical toxicology, and serology. |
| Notes: Source: (1) Code of Federal Regulations #42, Public Health, Section 493.2. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 186. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699382481 | Elicia A Liebe | Clinical Medical Laboratory | 4733 W Montana St, Milwaukee, WI 53219-3375 | 2020-09-26 |
| 1881203826 | Quest Diagnostics LLC Il | Clinical Medical Laboratory | 4852 S 6th St, Milwaukee, WI 53221-2462 | 2020-07-27 |
| 1043854144 | Stemina Biomarker Discovery, Inc. | Clinical Medical Laboratory | 504 S Rosa Rd Ste 150, Madison, WI 53719-1218 | 2019-10-31 |
| 1881238269 | Derek Raymond Schindler | Clinical Medical Laboratory | 680 Baker Rd, Hudson, WI 54016-7901 | 2019-10-29 |
| 1487296307 | Exact Sciences Laboratories, LLC | Clinical Medical Laboratory | 650 Forward Drive, Madison, WI 53711 | 2019-10-11 |
| 1003391269 | Precise Testing LLC | Clinical Medical Laboratory | 6815 W Capitol Dr Ste 105, Milwaukee, WI 53216-2056 | 2018-10-03 |
| 1992286074 | Rprd Diagnostics LLC | Clinical Medical Laboratory | 1225 Discovery Parkway, Suite 260, Milwaukee, WI 53226 | 2018-08-27 |
| 1164938916 | Tai Diagnostics, Inc. | Clinical Medical Laboratory | 10101 W Innovation Dr Ste 600, Wauwatosa, WI 53226-4824 | 2017-12-15 |
| 1831619535 | Laboratory Corporation of America | Clinical Medical Laboratory | 1111 Delafield St Ste 301, Waukesha, WI 53188-3407 | 2017-06-23 |
| 1558896498 | Noah Associates Incorporated | Clinical Medical Laboratory | 10501 W Greenfield Ave, West Allis, WI 53214-2421 | 2017-04-28 |
| Find all providers with the same taxonomy | ||||
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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.