KENOSHA PATHOLOGY CONSULTANTS (NPI# 1790812857) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790812857 |
| Entity Type | Organization |
| Organization Name | KENOSHA PATHOLOGY CONSULTANTS |
| Practice Address |
6308 8th Ave Kenosha WI 53143-5031 |
| Mailing Address |
Po Box 130 Kenosha WI 53141-0130 |
| Practice Telephone | 2626563063 |
| Practice Fax Number | 2626562749 |
| Mailing Telephone | 2626563063 |
| Mailing Fax Number | 2626562749 |
| Enumeration Date | 2007-02-27 |
| Last Update Date | 2008-03-06 |
| Authorized Official Name | SUSAN K COOPER (MANAGER) |
| Authorized Official Telephone | 2626562718 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207ZP0102X |
Pathology Specialization: Anatomic Pathology & Clinical Pathology |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 32873400 | 05 |
| Street Address |
6308 8TH AVE |
| City | KENOSHA |
| State | WI |
| Zip Code | 53143-5031 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366440851 | Janet S Barney | Nurse Practitioner | 6308 8th Ave, Suite 2000, Kenosha, WI 53143-5031 | 2005-07-08 |
| 1669094165 | Simona Slavinskiene | Nurse Practitioner | 6308 8th Ave, Kenosha, WI 53143-5031 | 2020-05-07 |
| 1366063133 | Lisa Neyens | Pharmacist | 6308 8th Ave, Kenosha, WI 53143-5031 | 2020-05-02 |
| 1164056727 | Michael James Church | Physician Assistant | 6308 8th Ave, Kenosha, WI 53143-5031 | 2020-02-23 |
| 1215593009 | Ihc-wound Care Services LLC | Emergency Medicine | 6308 8th Ave, Kenosha, WI 53143-5031 | 2019-05-16 |
| 1609358357 | Samantha M Rhodes | Physical Therapist | 6308 8th Ave, Kenosha, WI 53143-5031 | 2018-08-29 |
| 1063953784 | Megan Roethle | Registered Nurse | 6308 8th Ave, Kenosha, WI 53143-5031 | 2017-03-14 |
| 1043678683 | Sarah Rens | Physician Assistant | 6308 8th Ave, Kenosha, WI 53143-5031 | 2016-02-09 |
| 1922472422 | Catherine A Hernandez | Physician Assistant | 6308 8th Ave, Kenosha, WI 53143-5031 | 2015-11-20 |
| 1750779856 | Elliot M Simon | Physician Assistant | 6308 8th Ave, Suite 1020, Kenosha, WI 53143-5031 | 2014-12-26 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891262275 | Shanda L Goecks | Registered Nurse | 6916 26th Ave, Kenosha, WI 53143 | 2018-10-24 |
| 1689942989 | Racine Kenosha Community Action Agency | Public Health or Welfare | 2000 63rd Street, Kenosha, WI 53143 | 2011-12-01 |
| 1538497797 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 7525 Sheridan Rd, Kenosha, WI 53143 | 2009-11-30 |
| 1497929012 | Ebba M Johnson | Physical Therapist | 524 74th Street, Kenosha, WI 53143 | 2008-04-15 |
| 1770789489 | Kenosha Community Health Center, Inc | Family Medicine | 6226 14th Ave, Kenosha, WI 53143 | 2007-06-21 |
| 1558413161 | Junith M Thompson | Obstetrics & Gynecology | 6530 Sheridan Road, Kenosha, WI 53143 | 2007-01-17 |
| 1154471332 | Ljh Ambulance, Inc | Ambulance | 6329 28th Ave, Kenosha, WI 53143 | 2007-01-11 |
| 1578625794 | Michael A Schellpfeffer Md Ob Gyn Sc | Obstetrics & Gynecology | 1400 75th Street, Kenosha, WI 53143 | 2006-12-14 |
| 1457468654 | Yasmine S Sido | Physician Assistant | 7550 22nd Ave, Kenosha, WI 53143 | 2006-08-24 |
| 1356307359 | Nancy Jane Houtchens | Dentist | 7533 22nd Ave, Ste 100, Kenosha, WI 53143 | 2006-04-26 |
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| Taxonomy Code | 207ZP0102X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pathology |
| Specialization | Anatomic Pathology & Clinical Pathology |
| A pathologist deals with the causes and nature of disease and contributes to diagnosis, prognosis and treatment through knowledge gained by the laboratory application of the biologic, chemical and physical sciences. A pathologist uses information gathered from the microscopic examination of tissue specimens, cells and body fluids, and from clinical laboratory tests on body fluids and secretions for the diagnosis, exclusion and monitoring of disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added, 7/1/2009: definition reformatted] Additional Resources: American Board of Pathology, 2007. http://www.abpath.org/ This taxonomy code identifies the combined anatomic pathology & clinical pathology route. Board certification for Medical Doctors (MDs) is provided by the American Board of Pathology. To acknowledge the diverse activities in the practice of pathology and to accommodate the interests of individuals wanting to enter the field, the ABP offers primary certification through the following three routes: combined anatomic pathology and clinical pathology, anatomic pathology only and clinical pathology only. Primary certification in anatomic pathology or clinical pathology may be combined with some of the subspecialty certifications. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598927444 | Leela C Thachenkary | Pathology | 7107-49th Ave, Kenosha, WI 53142 | 2008-07-01 |
| 1851326094 | Maysoon A Razzak | Pathology | 10400 75th Street, Kenosha, WI 53142-7884 | 2006-07-12 |
| 1104075357 | Jamie Rae Mings | Pathology | 6308 8th Ave, Kenosha, WI 53143-5031 | 2008-09-11 |
| 1033272174 | Mark R Vytlacil | Pathology | 6308 8th Ave, Kenosha, WI 53143-5031 | 2006-12-19 |
| 1467515593 | James C Kranz | Pathology | 6308 8th Ave, Kenosha, WI 53143-5031 | 2006-12-19 |
| 1083791123 | Robert Bjork | Pathology | 6308 8th Ave, Kenosha, WI 53143-5031 | 2006-11-01 |
| 1669407060 | David A Scalzo | Pathology | 10400 75th St, Kenosha, WI 53142-7884 | 2006-07-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992316533 | Andrii Puzyrenko | Pathology | 9200 W Wisconsin Ave Ste L83, Milwaukee, WI 53226-3522 | 2020-08-16 |
| 1487040127 | Michelle Stoffel | Pathology | Uw Hospital and Clinics, 600 Highland Ave, Madison, WI 53792 | 2015-04-09 |
| 1447694328 | Patrick Stephen Rush | Pathology | 600 Highland Ave. H4/831, Uw Hospital and Clinics, Madison, WI 53792 | 2013-04-23 |
| 1346501756 | James Murray Angevine | Pathology | 602 Mineral Pt Road, Apt 214, Madison, WI 53705-4577 | 2012-06-01 |
| 1023314549 | Stephen Lee Mcclellan | Pathology | N4656 Lakeshore Dr, Kewaunee, WI 54216-9794 | 2011-01-31 |
| 1922231414 | Darrell Peter Skarphol | Pathology | 2480 Edgewood Ct, Green Bay, WI 54302-4813 | 2009-08-31 |
| 1518110147 | Werner Adam Reis | Pathology | 839 N Jefferson St Ste 300, Milwaukee, WI 53202-3744 | 2008-10-28 |
| 1326211384 | Scott James Kantola | Pathology | 2800 Westhill Dr Ste 208, Wausau, WI 54401-3770 | 2008-04-10 |
| 1437355997 | Monica Goswami | Pathology | 10472 W Montana Ave, # 215, West Allis, WI 53227-3263 | 2007-06-22 |
| 1891827234 | Jay F Schamberg | Pathology | 8901 West Lincoln Ave., West Allis, WI 53227 | 2007-03-12 |
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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.