RENEE MARIE SMITH (NPI# 1750310900) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750310900 |
| Entity Type | Individual |
| Full Name | RENEE MARIE SMITH |
| Other Name | RENEE MARIE BLAVAT |
| Credential | MD |
| Practice Address |
110 E 5th Ave Antigo WI 54409-2710 |
| Mailing Address |
333 Pine Ridge Blvd Suite 1-905 Wausau WI 54401-4120 |
| Practice Telephone | 7156232351 |
| Mailing Telephone | 7158472000 |
| Enumeration Date | 2006-07-01 |
| Last Update Date | 2008-09-30 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 47244 | WI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | DEA | BB8982591 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760936942 | Renee Smith | Technician, Pathology | 18603 Blackmoor St, Detroit, MI 48234-3719 | 2016-08-05 |
| 1396084356 | Renee Cannon Smith | Registered Nurse | 10901 Wilson Blvd, Blythewood, SC 29016-9241 | 2013-02-11 |
| 1831441849 | Renee Marie Smith | Licensed Practical Nurse | 4213 Sibley Ave, Columbus, OH 43227-2458 | 2012-10-15 |
| 1457614844 | Renee Nichole Smith | Specialist | 10 Hemingway Ave Apt B44, New Rochelle, NY 10801-3245 | 2012-06-20 |
| 1427322064 | Renee Jean Smith | Physical Therapy Assistant | 1683a Garvin Rd, Cranberry Township, PA 16066-2301 | 2012-02-29 |
| 1942470463 | Renee A Smith | Licensed Practical Nurse | 16969 Ridge Rd, Holley, NY 14470-9344 | 2008-03-12 |
| 1881870673 | Renee W Smith | Counselor | 76-b Fulton Spring Dr, Alabaster, AL 35007 | 2008-01-11 |
| 1710030812 | Renee Elena Smith | Psychiatry & Neurology | 8301 Florence Ave Ste 301, Downey, CA 90240-3948 | 2007-01-19 |
| 1770632739 | Renee L Smith | Marriage & Family Therapist | 1515 S Oregon St, Yreka, CA 96097-3425 | 2007-01-09 |
| 1699714162 | Renee Smith | Pharmacist | 700 19th St S # 119, Birmingham, AL 35233-1927 | 2006-06-06 |
| Street Address |
110 E 5TH AVE |
| City | ANTIGO |
| State | WI |
| Zip Code | 54409-2710 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558343319 | James M Turnbull | General Practice | 110 E 5th Ave, Aspirus General Clinic, Antigo, WI 54409-2710 | 2005-11-17 |
| 1811343544 | Lesley Washatko | Physician Assistant | 110 E 5th Ave, Antigo, WI 54409-2710 | 2016-05-12 |
| 1790155182 | Heather Conn | Nurse Practitioner | 110 E 5th Ave, Antigo, WI 54409-2710 | 2015-09-29 |
| 1336548627 | Nathaniel Joseph Retrum | Physician Assistant | 110 E 5th Ave, Antigo, WI 54409-2710 | 2014-08-22 |
| 1548406416 | Jessica Marie Brandt | Physical Therapist | 110 E 5th Ave, Department of Physical Therapy, Antigo, WI 54409-2710 | 2008-12-26 |
| 1033309315 | Kathleen M Bender | Dietitian, Registered | 110 E 5th Ave, Antigo, WI 54409-2710 | 2007-08-01 |
| 1023233822 | Bonnie J Hessedal | Dietitian, Registered | 110 E 5th Ave, Antigo, WI 54409-2710 | 2007-04-16 |
| 1821151366 | Langlade Hospital Hotel Dieu of St Joseph of Antigo Wisconsin | Clinic/Center | 110 E 5th Ave, Antigo, WI 54409-2710 | 2006-12-18 |
| 1114037363 | Angela Buchman | Physician Assistant | 110 E 5th Ave, Antigo, WI 54409-2710 | 2006-08-30 |
| 1578679262 | John E Mckenna | Family Medicine | 110 E 5th Ave, Antigo, WI 54409-2710 | 2006-08-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407454036 | Jason Peter Cueny | Pharmacist | 200 E Highway 64, Antigo, WI 54409 | 2020-10-15 |
| 1770194524 | Christpher George Rowe | Technician | 825 Clermont S Apt 7, Antigo, WI 54409 | 2020-08-14 |
| 1033753512 | Joseph Gerger | Technician | 711 Badger Ave, Antigo, WI 54409 | 2019-10-29 |
| 1225368780 | Integrated Pain Solutions LLC | Clinic/Center | 2327 Neva Road, Antigo, WI 54409 | 2010-01-06 |
| 1558525212 | Jessica E Rosenberg | Social Worker | 310 South Superior Street, Antigo, WI 54409 | 2008-07-11 |
| 1053433292 | Raymond J Portman | Dentist | 705 Fifth Ave, Antigo, WI 54409 | 2007-04-06 |
| 1699801316 | Rick L Perkins | Obstetrics & Gynecology | Aspirus General Clinic, 110 East 5th Avenue, Antigo, WI 54409 | 2007-02-26 |
| 1205999646 | Earl J Roth | Chiropractor | 612 Century Ave, Antigo, WI 54409 | 2006-12-18 |
| 1811061187 | Rosanne Schermetzler | Occupational Therapist | 720 Ackley Street, Antigo, WI 54409 | 2006-11-20 |
| 1912084070 | Antigo Total Therapy & Sports Rehab Center Inc | Physical Therapist | 720 Askley Street, Antigo, WI 54409 | 2006-11-01 |
| Find all providers in zip 54409 | ||||
| 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 |
|---|---|---|---|---|
| 1396995379 | Charles A Heuss | Family Medicine | N2166 Maple Rd, Antigo, WI 54409-9014 | 2008-09-25 |
| 1730196668 | Steve A Weber | Family Medicine | 1111 Langlade Road, Antigo, WI 54409 | 2006-08-02 |
| 1548610579 | Crystal Lalonde | Family Medicine | 112 E 5th Ave, Antigo, WI 54409-2710 | 2016-06-21 |
| 1235499815 | Kyle Dembowiak | Family Medicine | 112 E 5th Ave, Antigo, WI 54409-2710 | 2012-05-17 |
| 1578679262 | John E Mckenna | Family Medicine | 110 E 5th Ave, Antigo, WI 54409-2710 | 2006-08-22 |
| 1194743419 | Theodore C Fox | Family Medicine | 110 E 5th Ave, Antigo, WI 54409-2710 | 2006-07-17 |
| 1972521383 | James O Moermond Jr. | Family Medicine | 110 E 5th Ave, Antigo, WI 54409-2710 | 2006-07-17 |
| 1477586402 | Gary M Hegranes | Family Medicine | 110 E 5th Ave, Antigo, WI 54409-2710 | 2006-07-10 |
| 1265466296 | Bartley R Kneeland | Family Medicine | 110 E 5th Ave, Antigo, WI 54409-2710 | 2006-07-10 |
| 1669405676 | Kristine E Flowers | Family Medicine | 110 E 5th Ave, Antigo, WI 54409-2710 | 2006-07-10 |
| Find all providers in ANTIGO | ||||
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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.