CAROLYN BLANC (NPI# 1790711620) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790711620 |
| Entity Type | Individual |
| Full Name | CAROLYN BLANC |
| Credential | MD |
| Practice Address |
520 W 3rd St Kimberly WI 54136-1300 |
| Mailing Address |
Po Box 8003 Appleton WI 54912-8003 |
| Practice Telephone | 9207887680 |
| Practice Fax Number | 9207887688 |
| Mailing Telephone | 9209963298 |
| Mailing Fax Number | 9207385787 |
| Enumeration Date | 2006-06-23 |
| Last Update Date | 2016-09-01 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 40082 | WI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | MEDICARE PTAN | 005945003 | 01 |
| WI | 3256100 | 05 |
| Street Address |
520 W 3RD ST |
| City | KIMBERLY |
| State | WI |
| Zip Code | 54136-1300 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497033609 | Katherine Lynn Erstad | Nurse Practitioner | 520 W 3rd St, Kimberly, WI 54136-1300 | 2011-07-22 |
| 1740578855 | Rebecca Kristeen Doro | Family Medicine | 520 W 3rd St, Kimberly, WI 54136-1300 | 2011-07-11 |
| 1851478853 | Michelle M Lehr | Nurse Practitioner | 520 W 3rd St, Kimberly, WI 54136-1300 | 2006-11-01 |
| 1821006271 | Joyce Bauer | Family Medicine | 520 W 3rd St, Kimberly, WI 54136-1300 | 2006-08-03 |
| 1063439420 | Montgomery Elmer | Family Medicine | 520 W 3rd St, Kimberly, WI 54136-1300 | 2006-07-16 |
| 1306886601 | Sarah K Marcoe | Family Medicine | 520 W 3rd St, Kimberly, WI 54136-1300 | 2006-06-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528689361 | Hsl 15, LLC | Assisted Living Facility | 2795 Village Square Drive, Hartland, WI 54136 | 2020-05-04 |
| 1356417067 | James Robert Boots | Chiropractor | 1020 Truman Street, Suite B, Kimberly, WI 54136 | 2006-11-27 |
| 1568572477 | Glen E Rooyakkers | Chiropractor | 702 Eisenhower Drive, Suite G, Kimberly, WI 54136 | 2006-08-30 |
| 1225148133 | Tri County Chiropractic Sc | Chiropractor | 702 Eisenhower Drive Suite G, Kimberly, WI 54136 | 2006-08-30 |
| 1548273808 | Edward Theodore Bekx | Dentist | 203 W Kimberly Ave, Kimberly, WI 54136 | 2006-08-15 |
| 1477583870 | Joseph C Ferraro | Dentist | 1037-b Truman St., Kimberly, WI 54136 | 2006-07-03 |
| 1770964124 | Building Hope Therapy Services LLC | Occupational Therapist | 1113 W Kennedy Ave Ste E, Kimberly, WI 54136 | 2015-06-11 |
| 1770693681 | Wanda J Rooyakkers | Chiropractor | 702 Eisenhower Drive, Suite G, Kimberly, WI 54136 | 2006-08-30 |
| 1790798056 | Kimberly Dental Associates LLP | Dentist | 203 W Kimberly Ave, Kimberly, WI 54136 | 2006-08-15 |
| 1407869761 | Robert Alan Magnin | Dentist | 203 W Kimberly Ave, Kimberly, WI 54136 | 2006-08-15 |
| Find all providers in zip 54136 | ||||
| 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 |
|---|---|---|---|---|
| 1740578855 | Rebecca Kristeen Doro | Family Medicine | 520 W 3rd St, Kimberly, WI 54136-1300 | 2011-07-11 |
| 1821006271 | Joyce Bauer | Family Medicine | 520 W 3rd St, Kimberly, WI 54136-1300 | 2006-08-03 |
| 1063439420 | Montgomery Elmer | Family Medicine | 520 W 3rd St, Kimberly, WI 54136-1300 | 2006-07-16 |
| 1306886601 | Sarah K Marcoe | Family Medicine | 520 W 3rd St, Kimberly, WI 54136-1300 | 2006-06-07 |
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|---|---|---|---|---|
| 1104426477 | St Gianna Molla Clinic, Inc | Family Medicine | 20 Pinewild Ct, Appleton, WI 54913-7127 | 2020-10-27 |
| 1962015552 | Callie Lund | Family Medicine | 418 Lotus St, Mosinee, WI 54455-1728 | 2020-08-25 |
| 1275159998 | Beam Healthcare, Sc | Family Medicine | 25 W Main St Fl 5, Madison, WI 53703-3399 | 2020-06-18 |
| 1487283503 | Enitza Damaris George | Family Medicine | 1906 Brackett Ave, Eau Claire, WI 54701-5042 | 2020-04-02 |
| 1093341380 | Tia Marie Vaccaro | Family Medicine | 1275 Judd Rd, Oregon, WI 53575-2573 | 2020-03-18 |
| 1134753411 | Proactive Md Sc,p.a. | Family Medicine | Brakebush Health Center, N4993 6th Dr., Westfield, WI 53964 | 2020-02-26 |
| 1790323608 | Solidaritus Health Wisconsin Sc | Family Medicine | 1476 Blazing Star Blvd Ste 4, Altoona, WI 54720-4002 | 2019-12-11 |
| 1255974952 | Integrative Health Center of Central Wisconsin LLC | Family Medicine | 3205 E Washington Ave Ste A, Madison, WI 53704-4332 | 2019-10-25 |
| 1962969220 | Paladina Health, LLC | Family Medicine | Paladina Health Menomonee Falls, N84 W15787 Menomonee Avenue Suite 6, Menomonee Falls, WI 53051 | 2019-02-22 |
| 1942767298 | Paladina Health, LLC | Family Medicine | Paladina Health Sussex Beer Capitol Clinic, W222 N5700 Miller Way, Sussex, WI 53069 | 2019-02-22 |
| 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.