MS. MARY JO P WIEMILLER (NPI# 1689628703) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689628703 |
| Entity Type | Individual |
| Full Name | MS. MARY JO P WIEMILLER |
| Other Name | MS. MARY JO MATZKE |
| Credential | PA |
| Practice Address |
945 N 12th St Milwaukee WI 53233-1305 |
| Practice Telephone | 4142197880 |
| Mailing Telephone | 4142197880 |
| Enumeration Date | 2006-05-22 |
| Last Update Date | 2013-09-05 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
1621 | WI | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| HUMANA | 006806261B | 01 | |
| WI | 41975200 | 05 |
| Street Address |
945 N 12TH ST |
| City | MILWAUKEE |
| State | WI |
| Zip Code | 53233-1305 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811996796 | Marilynn E Frederiksen | Obstetrics & Gynecology | 945 N 12th St, Milwaukee, WI 53233-1305 | 2005-07-21 |
| 1104437375 | Danielle Steinke | Physical Therapist | 945 N 12th St, Milwaukee, WI 53233-1305 | 2020-08-12 |
| 1477171916 | Rachel Weiss | Dietitian, Registered | 945 N 12th St, Milwaukee, WI 53233-1305 | 2020-07-10 |
| 1427675230 | Nicholas Dimitri Nassif | Student in an Organized Health Care Education/Training Program | 945 N 12th St, Milwaukee, WI 53233-1305 | 2020-06-26 |
| 1467076935 | Victoria K Iadarola | Physician Assistant | 945 N 12th St, Milwaukee, WI 53233-1305 | 2020-06-01 |
| 1982226676 | Mariann Delores Sykes | Massage Therapist | 945 N 12th St, Milwaukee, WI 53233-1337 | 2020-05-15 |
| 1992325112 | Tom Robert Straus | Occupational Therapist | 945 N 12th St, Milwaukee, WI 53233-1305 | 2020-04-17 |
| 1881213304 | Melissa Hunter | Physical Therapist | 945 N 12th St, Milwaukee, WI 53233-1305 | 2020-04-14 |
| 1891314373 | Nicholas Medek | Physical Therapy Assistant | 945 N 12th St, Milwaukee, WI 53233-1305 | 2020-04-14 |
| 1447889811 | Mounika Paravastu | Student in an Organized Health Care Education/Training Program | 945 N 12th St, Milwaukee, WI 53233-1305 | 2020-04-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104454750 | Henok Desta Hardilo | Student in an Organized Health Care Education/Training Program | Aurora Sinai Medical Center 945 N 12th Street, Milwaukee, WI 53233 | 2020-03-30 |
| 1821633314 | Ann E Millard | Occupational Therapist | 560 N. 16th Street, Room 214a, Milwaukee, WI 53233 | 2019-11-08 |
| 1306480918 | Teng Kai Ong | Dentist | 1801 West Wisconsin Ave., Milwaukee, WI 53233 | 2019-11-06 |
| 1356800478 | Nebiyu Abera Tilahun | Student in an Organized Health Care Education/Training Program | Aurora Sinai Medical Center, 945 N. 12th Street, Milwaukee, WI 53233 | 2019-03-18 |
| 1548748387 | Emily Claire Goetz | Physical Therapist | 945 N. 12th St. Suite 1100, Milwaukee, WI 53233 | 2018-08-03 |
| 1801373378 | Froedtert & The Medical College of Wisconsin Community Physicians | Non-Pharmacy Dispensing Site | 1721 W Canal St, Milwaukee, WI 53233 | 2018-07-26 |
| 1184170706 | Lauren Troll | Physical Therapist | 925 N 12th Street, Milwaukee, WI 53233 | 2016-09-01 |
| 1942694401 | Iryna Nemesh | Internal Medicine | 1020 N 12th St Fl 2, Milwaukee, WI 53233 | 2015-03-23 |
| 1649676032 | Matina Angelopoulou | Dentist | 1801 West Winsconsin Ave, Milwaukee, WI 53233 | 2014-11-12 |
| 1780007831 | John Ladisa | Technician, Other | 1637 W. Wisconsin Ave, Room 311, Milwaukee, WI 53233 | 2014-01-27 |
| Find all providers in zip 53233 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093085664 | Abraham David Pacheco | Physician Assistant | 3246 S 35th St, Milwaukee, WI 53215-4156 | 2012-01-12 |
| 1386603439 | Harland L Cook | Physician Assistant | 2315 M Lake Drive, #703, Milwaukee, WI 53211 | 2006-03-18 |
| 1871576256 | Kristin Ann Skoraczewski | Physician Assistant | 960 N 12th St, Suite 1800, Milwaukee, WI 53233-1306 | 2005-11-21 |
| 1144704677 | Jennifer Lynn Vanderpool | Physician Assistant | 2301 N Lake Dr, Milwaukee, WI 53211-4508 | 2018-09-20 |
| 1528554292 | Andrea Rakoczy | Physician Assistant | 9200 W Wisconsin Ave, Milwaukee, WI 53226-3522 | 2018-07-06 |
| 1639665763 | Lanie E Rudie | Physician Assistant | 9200 W Wisconsin Ave, Milwaukee, WI 53226 | 2018-07-01 |
| 1154815298 | Aaron Kleinertz | Physician Assistant | 9200 W Wisconsin Ave, Milwaukee, WI 53226 | 2018-06-21 |
| 1912419953 | Krista Chipman | Physician Assistant | 9000 W Wisconsin Ave, Milwaukee, WI 53226-4874 | 2017-10-31 |
| 1578086468 | Benjamin Ingram | Physician Assistant | 9200 W Wisconsin Ave, Milwaukee, WI 53226-3522 | 2017-07-21 |
| 1225481187 | Taylor Boyle | Physician Assistant | 9200 W Wisconsin Ave, Milwaukee, WI 53226-3522 | 2016-07-15 |
| Find all providers in MILWAUKEE | ||||
Please comment or provide details below to improve the information on MS. MARY JO P WIEMILLER.
| 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.