WISCONSIN VISITING PODIATRY (NPI# 1790158368) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790158368 |
| Entity Type | Organization |
| Organization Name | WISCONSIN VISITING PODIATRY |
| Practice Address |
28606 Sandpiper Trl Waterford WI 53185-1733 |
| Mailing Address |
6400 Industrial Loop Greendale WI 53129-2452 |
| Practice Telephone | 2242347304 |
| Mailing Telephone | 4144234100 |
| Mailing Fax Number | 4144234134 |
| Enumeration Date | 2015-11-04 |
| Last Update Date | 2015-11-04 |
| Authorized Official Name | RICHARD KENNISON (OWNER) |
| Authorized Official Telephone | 2242347304 |
| Authorized Official Credential | DPM |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
Podiatric Medicine & Surgery Service Providers |
| Street Address |
28606 SANDPIPER TRL |
| City | WATERFORD |
| State | WI |
| Zip Code | 53185-1733 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649755695 | Alyssa Jane Revolinski | Respite Care | 269435 S Elm Lane, Waterford, WI 53185 | 2018-09-26 |
| 1871973370 | Julie Minikowski | Community Health Worker | 207 Milwaukee Avenue, A, Waterford, WI 53185 | 2015-06-01 |
| 1629235031 | Fluegge Optical | Technician/Technologist | 920 E Main Street, Waterford, WI 53185 | 2008-05-22 |
| 1659598209 | Julie Michals | Occupational Therapist | 1701 Sharp Road, Waterford, WI 53185 | 2007-04-18 |
| 1518072768 | Jennifer Jayne Decker | Family Medicine | 818 Forrest Ln, Waterford, WI 53185 | 2006-08-20 |
| 1215966908 | Amy Beth Flock | Physical Therapy Assistant | 2319 Fox Knoll Dr, Waterford, WI 53185 | 2006-07-03 |
| 1750762472 | Tesalia R Renteria | Family Medicine | 818 Forest Ln, Waterford, WI 53185 | 2015-06-18 |
| 1649651092 | Kathryn C Halyko | Pediatrics | 818 Forest Ln, Waterford, WI 53185 | 2015-06-11 |
| 1518109735 | Daniel A Allison | Family Medicine | 818 Forest Ln, Waterford, WI 53185 | 2009-04-02 |
| 1811178478 | Daniel Mark Gifford | Speech-Language Pathologist | 1701 Sharp Rd, Lakeview Specialty Hospital, Waterford, WI 53185 | 2007-11-23 |
| Find all providers in zip 53185 | ||||
| Taxonomy Code | 213ES0103X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| Specialization | Foot & Ankle Surgery |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598772105 | Jeffrey D. Danto | Podiatrist | 4396 Dixie Hwy Ste 1, Waterford, MI 48329-3564 | 2006-08-03 |
| 1457331357 | John Michael Gaetano | Podiatrist | 914 Hartford Turnpike, Waterford, CT 06385 | 2006-01-18 |
| 1912906751 | Kris A Haase | Podiatrist | 7116 Highland Rd, Waterford, MI 48327-1503 | 2005-07-14 |
| 1316393309 | Great Lakes Podiatry Associates Pllc | Podiatrist | 3560 Pontiac Lake Rd, Waterford, MI 48328-2337 | 2016-05-09 |
| 1194901504 | Allegheny Foot & Ankle Center, LLC | Podiatrist | 914 Hartford Tpke, Waterford, CT 06385-4263 | 2008-01-15 |
| 1538285036 | Michigan Associates In Podiatric Medicine and Surgery PC | Podiatrist | 3560 Pontiac Lake Rd, Waterford, MI 48328-2337 | 2007-03-22 |
| 1386758852 | Sheldon J Goldstein | Podiatrist | 3560 Pontiac Lake Rd, Waterford, MI 48328-2337 | 2006-08-19 |
| 1922054220 | Kris A Haase Dpm Plc | Podiatrist | 7116 Highland Rd, Waterford, MI 48327-1503 | 2006-05-26 |
| 1750357083 | Jack D Janigian | Podiatrist | 950 N Cass Lake Rd, Waterford, MI 48328-2370 | 2006-02-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225675697 | Grayco LLC | Podiatrist | 7128 Tamarack Ct, Mequon, WI 53092-8517 | 2019-12-04 |
| 1124688114 | Foot Factor Podiatry LLC | Podiatrist | 6125 Green Bay Rd Ste 600, Kenosha, WI 53142-2928 | 2019-06-20 |
| 1063928752 | Sheboygan Foot Care, LLC | Podiatrist | 630 Riverfront Dr Ste 202, Sheboygan, WI 53081-4616 | 2017-12-18 |
| 1295279461 | Colin T Graney | Podiatrist | 664 W. Washington Ave, Madison, WI 53703 | 2016-12-07 |
| 1225415540 | Alexander Blaschke | Podiatrist | 1009 Caledonia St, La Crosse, WI 54603 | 2015-05-06 |
| 1164861712 | Jessica Leigh Minder | Podiatrist | W62n179 Washington Ave Ste 3, Cedarburg, WI 53012-2770 | 2013-06-17 |
| 1326322884 | Northwoods Foot & Ankle LLC | Podiatrist | 1400 Us Highway 51 N, Unit G, Arbor Vitae, WI 54568-9504 | 2011-10-03 |
| 1336434075 | James David Torhorst | Podiatrist | 1439 Churchill St # 202, Waupaca, WI 54981-2089 | 2011-06-10 |
| 1154632412 | Anton John Sella | Podiatrist | 2835 N Grandview Blvd Ste 300, Pewaukee, WI 53072-5591 | 2010-07-01 |
| 1861627184 | Ivelisse Vargas Jon | Podiatrist | 6510 W Layton Ave Ste 102, Greenfield, WI 53220-4563 | 2009-05-17 |
| Find all providers with the same taxonomy | ||||
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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.