JILL M WAGNER (NPI# 1699881425) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699881425 |
| Entity Type | Individual |
| Full Name | JILL M WAGNER |
| Credential | M.D. |
| Practice Address |
9252 N Green Bay Rd Brown Deer WI 53209 |
| Mailing Address |
9252 N Green Bay Rd Brown Deer WI 53209-1104 |
| Practice Telephone | 4145277500 |
| Practice Fax Number | 4143656320 |
| Mailing Telephone | 4145277500 |
| Mailing Fax Number | 4143656320 |
| Enumeration Date | 2006-08-22 |
| Last Update Date | 2018-08-16 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 40255 | WI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 34377700 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568638351 | Jill Wagner | Registered Nurse | 154 N 15th Ave, West Bend, WI 53095-3023 | 2008-05-01 |
| 1487119343 | Jill Wagner | Nurse's Aide | 7710 W Ih 10, San Antonio, TX 78230-4711 | 2019-02-05 |
| 1992294987 | Jill Marie Wagner | Health Educator | 704 1st Dr Nw, Austin, MN 55912-3099 | 2018-05-04 |
| 1043724206 | Jill Christine Wagner | Social Worker | 200 1st St Sw, Rochester, MN 55905-0001 | 2017-11-27 |
| 1932596582 | Jill Wagner | Pharmacist | 410 W 10th Ave, Columbus, OH 43210-1240 | 2015-04-22 |
| 1518290360 | Jill Karen Wagner | Physical Therapist | 450 W Broad St, Suite 214-a, Falls Church, VA 22046-3340 | 2009-09-11 |
| 1023097516 | Jill M Wagner | Obstetrics & Gynecology | 306 Westwood Ave, Suite 501, High Point, NC 27262-4341 | 2006-01-12 |
| Street Address |
9252 N GREEN BAY RD |
| City | BROWN DEER |
| State | WI |
| Zip Code | 53209 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669470134 | Soliven C Bautista | Physical Medicine & Rehabilitation | 9252 N Green Bay Rd, Brown Deer, WI 53209-1104 | 2005-07-08 |
| 1023644531 | Matthew Michael | Physical Therapist | 9252 N Green Bay Rd, Brown Deer, WI 53209-1104 | 2020-03-16 |
| 1427517408 | Ascension Wisconsin Pharmacy, Inc. | Pharmacy | 9252 N Green Bay Rd, Brown Deer, WI 53209-1104 | 2019-03-18 |
| 1679031629 | Allie Knaus | Physical Therapist | 9252 N Green Bay Rd, Brown Deer, WI 53209-1104 | 2019-03-08 |
| 1700356557 | Emily M Samuel | Physician Assistant | 9252 N Green Bay Rd, Brown Deer, WI 53209-1104 | 2018-12-04 |
| 1225514656 | Lori Komisar | Registered Nurse | 9252 N Green Bay Rd, Brown Deer, WI 53209-1104 | 2018-07-18 |
| 1891240610 | Nate Sullivan | Nurse Practitioner | 9252 N Green Bay Rd, Brown Deer, WI 53209-1104 | 2016-08-22 |
| 1366849952 | Cesar Sison | Occupational Therapist | 9252 N Green Bay Rd, Brown Deer, WI 53209-1104 | 2014-11-25 |
| 1518360882 | Amy Prout | Dietitian, Registered | 9252 N Green Bay Rd, Brown Deer, WI 53209-1104 | 2014-10-01 |
| 1255512141 | Marina L. Kropp | Physical Medicine & Rehabilitation | 9252 N Green Bay Rd, Brown Deer, WI 53209-1104 | 2007-11-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780238253 | Niajcia Brookshire | Counselor | 3900 W Brown Deer Rd Suite 200, Brown Deer, WI 53209 | 2019-08-01 |
| 1740751015 | Mary Fuller | Home Health Aide | 3043 N 29th St., Milwaukee, WI 53209 | 2018-12-16 |
| 1154869410 | Jacksonscott2 | Skilled Nursing Facility | 4573 N. 22nd Street, Milwaukee, WI 53209 | 2017-02-07 |
| 1669910469 | Dimera House | In Home Supportive Care | 4002 W Fairount Ave, Milwaukee, WI 53209 | 2017-02-01 |
| 1891248340 | Amy L May | Nurse Practitioner | 3303 W Good Hope Rd, Milwaukee, WI 53209 | 2016-08-02 |
| 1871980193 | Alan R Rosenthal | Pharmacist | 6930 N Beech Tree Dr, Milwaukee, WI 53209 | 2015-04-24 |
| 1104212380 | Reema Shah | Student in an Organized Health Care Education/Training Program | 2400 W. Villard Ave, Milwaukee, WI 53209 | 2015-04-14 |
| 1336534403 | Robert Michael Kitsis | Family Medicine | 9252 N Green Bay Rd Fl 2, Brown Deer, WI 53209 | 2015-04-05 |
| 1962891994 | Kls Community Outreach Teen Center Consulting and Management L.L.C. | Public Health or Welfare | 8330 North Teutonia Ave Suite 103, Brown Deer, WI 53209 | 2015-01-14 |
| 1548659634 | Kls Community Outreach Teen Center Consulting and Management L.L.C. | Early Intervention Provider Agency | 8330 North Teutonia Avenue Suite 103, Brown Deer, WI 53209 | 2015-01-13 |
| Find all providers in zip 53209 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336534403 | Robert Michael Kitsis | Family Medicine | 9252 N Green Bay Rd Fl 2, Brown Deer, WI 53209 | 2015-04-05 |
| 1588746853 | Wheaton Franciscan Medical Group | Family Medicine | 4301 W Brown Deer Rd, Brown Deer, WI 53223-2400 | 2006-10-19 |
| 1831204338 | Francisca A Olmedo-estrada | Family Medicine | 9233 N Green Bay Road, Brown Deer, WI 53209 | 2006-08-21 |
| 1801844253 | Paul P Hartlaub | Family Medicine | 9252 N Green Bay Road, Brown Deer, WI 53209-1104 | 2006-05-05 |
| 1982665394 | Michael F Johnstone | Family Medicine | 9233 N Green Bay Rd, Brown Deer, WI 53209-1103 | 2006-03-28 |
| 1447320510 | Shannon Sarah Muderlak | Family Medicine | 9252 N Green Bay Rd, Brown Deer, WI 53209-1104 | 2006-11-08 |
| 1861574691 | David Hadcock | Family Medicine | 9233 N Green Bay Rd, Brown Deer, WI 53209-1103 | 2006-10-20 |
| 1184730079 | Sean Patrick Ronayne | Family Medicine | 9252 N Green Bay Rd, Brown Deer, WI 53209-1104 | 2006-08-22 |
| 1841306636 | Melissa Walbrandt | Family Medicine | 9252 N Green Bay Rd, Brown Deer, WI 53209-1104 | 2006-08-22 |
| 1528080900 | Matthew M Richlen | Family Medicine | 9252 N Green Bay Rd, Brown Deer, WI 53209-1104 | 2006-07-24 |
| Find all providers in BROWN DEER | ||||
| City | BROWN DEER |
| Zip Code | 53209 |
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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.