MICHAEL JASON BLACK (NPI# 1720036387) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720036387 |
| Entity Type | Individual |
| Full Name | MICHAEL JASON BLACK |
| Credential | M.D. |
| Practice Address |
1818 N Meade St Suite 240 West Appleton WI 54911-3496 |
| Practice Telephone | 9207318131 |
| Practice Fax Number | 9208320444 |
| Mailing Telephone | 9207318131 |
| Mailing Fax Number | 9208320444 |
| Enumeration Date | 2006-05-05 |
| Last Update Date | 2008-10-27 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208600000X | Surgery | 46688-020 | WI | Allopathic & Osteopathic Physicians |
| N | 208600000X | Surgery | 46688 | WI | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699061390 | Michael Richard Black | Psychologist | 2913 N Commonwealth Ave Rm 301, Saint Joseph Hospital Campus, Manor Building, Chicago, IL 60657-6211 | 2011-06-22 |
| 1659392256 | Michael Darryl Black | Surgery | 927 45th St Ste 301, West Palm Beach, FL 33407-2450 | 2006-07-21 |
| 1437703873 | Michael Anthony Black | Counselor | 230 Main Street Ext, Middletown, CT 06457-4470 | 2019-07-24 |
| 1104488816 | Michael David Black | Occupational Therapist | 600 N Robbins Rd, Boise, ID 83702-4565 | 2019-07-02 |
| 1376016873 | Michael Vincent Black | Specialist/Technologist | 535 E 70th St, New York, NY 10021-4823 | 2019-01-07 |
| 1750858072 | Michael R Black | Registered Nurse | 901 Rainier Ave S, Seattle, WA 98144-2839 | 2018-10-24 |
| 1134652217 | Michael Black | Student in an Organized Health Care Education/Training Program | 700 Lawrence Expy, Santa Clara, CA 95051-5173 | 2017-04-06 |
| 1780124560 | Michael W Black | Case Manager/Care Coordinator | 65 Messimer Dr, Newark, OH 43055-1874 | 2017-02-28 |
| 1851732499 | Michael Anthony Black | Marriage & Family Therapist | 1313 E Maple St, Bellingham, WA 98225-5708 | 2013-07-11 |
| 1952655888 | Michael Emery Black | Physical Therapist | 2525 S 135th Ave, Omaha, NE 68144-2424 | 2012-10-30 |
| Street Address |
1818 N MEADE ST SUITE 240 WEST |
| City | APPLETON |
| State | WI |
| Zip Code | 54911-3496 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588666853 | Appleton Emergency Services S C | Emergency Medicine | 1818 N Meade St, Appleton, WI 54911-3454 | 2005-06-01 |
| 1720691553 | Katie Jo Bares | Physical Therapist | 1818 N Meade St, Appleton, WI 54911-3454 | 2020-08-31 |
| 1306454053 | Samantha L Thiede | Nurse Practitioner | 1818 N Meade St, Appleton, WI 54911-3454 | 2020-07-20 |
| 1346867272 | Lauren Renee Schauer | Registered Nurse | 1818 N Meade St, Appleton, WI 54911-3454 | 2020-06-26 |
| 1790309755 | Lane Baumbach | Dietitian, Registered | 1818 N Meade St, Appleton, WI 54911-3454 | 2020-06-04 |
| 1326661026 | Thedacare Regional Medical Center - Appleton, Inc. | Medicare Defined Swing Bed Unit | 1818 N Meade St, Appleton, WI 54911-3454 | 2020-05-28 |
| 1568095016 | Samantha Putzer | Physician Assistant | 1818 N Meade St, Appleton, WI 54911-3454 | 2020-02-12 |
| 1083245120 | Krystina L Putnam | Registered Nurse | 1818 N Meade St, Appleton, WI 54911-3454 | 2020-01-28 |
| 1366097040 | Kelsey G Alt | Physician Assistant | 1818 N Meade St, Appleton, WI 54911-3454 | 2019-08-08 |
| 1528611217 | Abigail M Witthuhn | Physician Assistant | 1818 N Meade St, Appleton, WI 54911-3454 | 2019-07-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912545633 | Brotherly Love, LLC | Day Training, Developmentally Disabled Services | 1513 E Frances St, Appleton, WI 54911 | 2019-12-12 |
| 1952952129 | Eagle Point Senior Living Inc | Assisted Living Facility | 995 East John Street, Appleton, WI 54911 | 2019-09-27 |
| 1619524766 | University Rx LLC | Pharmacy | 133 E College Ave, Appleton, WI 54911 | 2019-08-23 |
| 1174080063 | Shayla Russell | Counselor | Outagamie County Health and Human Services, 320 S. Walnut St., Appleton, WI 54911 | 2019-02-27 |
| 1871086645 | Megan Kilsdonk | Health Educator | 1604 N Meade St, Appleton, WI 54911 | 2018-06-07 |
| 1871085480 | Tanya Lynn Vickery | Social Worker | 410 S. Elm St., Appleton, WI 54911 | 2018-05-31 |
| 1013407501 | Teri G Metropulos | Counselor | 229 S. Morrison, Appleton, WI 54911 | 2018-05-10 |
| 1093211211 | Bonnie Anne Korytkowski | Student in an Organized Health Care Education/Training Program | 229 S. Morrison Street, Appleton, WI 54911 | 2018-04-05 |
| 1639673940 | Brett Follett | Psychologist | 401 S. Elm St., Appleton, WI 54911 | 2018-03-21 |
| 1700202892 | Brian Withrow | Counselor | 607 West 7th St., Appleton, WI 54911 | 2014-03-13 |
| Find all providers in zip 54911 | ||||
| Taxonomy Code | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912155250 | Eric Jon Stanelle | Surgery | 1818 N Meade St # 240w, Appleton, WI 54911-3454 | 2008-08-28 |
| 1225022254 | George R Stanis | Surgery | 1501 S Madison St, Appleton, WI 54915-1846 | 2005-09-06 |
| 1447242573 | Thomas M Wascher | Surgery | 5320 Michaels Dr, Appleton, WI 54913-8446 | 2005-08-16 |
| 1376535492 | Karl A Greene | Surgery | 5320 West Michaels Drive, Appleton, WI 54913 | 2005-08-16 |
| 1437412699 | Alexander Warren Wilkes | Surgery | 1818 N Meade St # 240w, Appleton, WI 54911-3454 | 2012-06-21 |
| 1164746301 | Janeil Mitchell | Surgery | 1818 N Meade St # 240w, Appleton, WI 54911-3454 | 2010-03-17 |
| 1174767271 | Ping D Lady | Surgery | 1501 S Madison St, Appleton, WI 54915-1846 | 2009-04-21 |
| 1134318181 | Beth R Krieger | Surgery | 1818 N Meade St, Suite 240 West, Appleton, WI 54911-3454 | 2007-10-16 |
| 1376594952 | Fox Valley Surgical Associates Ltd | Surgery | 1818 N Meade St, Suite 240 West, Appleton, WI 54911-3454 | 2006-05-16 |
| 1346226826 | Robert J Ferrante | Surgery | 1818 N Meade St, Suite N347, Appleton, WI 54911-3454 | 2005-12-16 |
| Find all providers in APPLETON | ||||
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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.