DR. SHAY NICHOLAS (NPI# 1700869526) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700869526 |
| Entity Type | Individual |
| Full Name | DR. SHAY NICHOLAS |
| Credential | M.D. |
| Practice Address |
744 S Webster Ave Green Bay WI 54301-3505 |
| Mailing Address |
6400 Industrial Loop Greendale WI 53129-2452 |
| Practice Telephone | 9204333500 |
| Practice Fax Number | 9204337932 |
| Mailing Telephone | 4144234100 |
| Mailing Fax Number | 4144234134 |
| Enumeration Date | 2005-11-25 |
| Last Update Date | 2014-04-24 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207P00000X | Emergency Medicine | 47159-020 | WI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 34554700 | 05 |
| Street Address |
744 S WEBSTER AVE |
| City | GREEN BAY |
| State | WI |
| Zip Code | 54301-3505 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851398283 | Sampoornima Setty | Internal Medicine | 744 S Webster Ave, Green Bay, WI 54301-3505 | 2005-06-30 |
| 1447858857 | Caycie N Bray | Physical Therapist | 744 S Webster Ave, Green Bay, WI 54301-3505 | 2020-10-16 |
| 1326645029 | Nikki Lee Leow | Registered Nurse | 744 S Webster Ave, Green Bay, WI 54301-3505 | 2020-10-06 |
| 1033726914 | Patricia M Slempkes | Occupational Therapist | 744 S Webster Ave, Green Bay, WI 54301-3505 | 2020-09-25 |
| 1255941746 | Cassandra Toellner | Anesthesiologist Assistant | 744 S Webster Ave, Green Bay, WI 54301-3505 | 2020-08-09 |
| 1376151951 | Dayna Elizabeth Schneider | Speech-Language Pathologist | 744 S Webster Ave, Green Bay, WI 54301-3505 | 2020-07-20 |
| 1164045092 | Robyn W Lauritsen | Registered Nurse | 744 S Webster Ave, Green Bay, WI 54301-3505 | 2020-05-27 |
| 1831711860 | Ashley Elizabeth Mijal | Nurse Practitioner | 744 S Webster Ave, Green Bay, WI 54301-3505 | 2020-05-13 |
| 1336760883 | Veronica B Hoppe | Pharmacist | 744 S Webster Ave, Green Bay, WI 54301-3505 | 2020-05-06 |
| 1386264521 | Brian Joseph Eggener | Radiology | 744 S Webster Ave, Green Bay, WI 54301-3505 | 2020-04-17 |
| Find all providers in the same location | ||||
| 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 | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437512613 | Jacob Tyler Clark | Emergency Medicine | 1035 Kepler Dr, Green Bay, WI 54311-8320 | 2016-04-04 |
| 1346275344 | William H Benn | Emergency Medicine | 2502 S Ashland Ave, Green Bay, WI 54304-5252 | 2006-07-11 |
| 1326090697 | Richard L Erdman | Emergency Medicine | 725 S Webster Ave, Green Bay, WI 54301-3500 | 2006-05-16 |
| 1063953313 | Daniel James Miller | Emergency Medicine | 2845 Greenbrier Rd, Green Bay, WI 54311-6519 | 2017-03-19 |
| 1922412279 | Kevin S. Dougherty | Emergency Medicine | 1726 Shawano Ave, Green Bay, WI 54303-3216 | 2014-06-15 |
| 1215355607 | William J Wagner | Emergency Medicine | 2845 Greenbrier Rd, Green Bay, WI 54311-6519 | 2014-04-02 |
| 1013352582 | Katie Lynn Lloyd | Emergency Medicine | 2845 Greenbrier Rd, Green Bay, WI 54311-6519 | 2013-05-09 |
| 1881951838 | Robert Paul Zemple | Emergency Medicine | 2845 Greenbrier Rd, Green Bay, WI 54311-6519 | 2012-04-16 |
| 1295021079 | Katrina Lynn Destree | Emergency Medicine | 2845 Greenbrier Rd, Green Bay, WI 54311-6519 | 2011-06-21 |
| 1962638064 | Christopher Britt Kolar | Emergency Medicine | 835 S Van Buren St, Green Bay, WI 54301-3526 | 2009-06-03 |
| Find all providers in GREEN BAY | ||||
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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.