PHILIP BUDIHARDJO (NPI# 1811198344) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811198344 |
| Entity Type | Individual |
| Full Name | PHILIP BUDIHARDJO |
| Credential | DO |
| Practice Address |
1969 W Hart Rd Beloit WI 53511 |
| Mailing Address |
340 Midland Rd Ste 120 Janesville WI 53546-2339 |
| Practice Telephone | 6083627888 |
| Mailing Telephone | 6087439313 |
| Mailing Fax Number | 6087439318 |
| Enumeration Date | 2007-05-31 |
| Last Update Date | 2018-07-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
3977 | IA | Allopathic & Osteopathic Physicians |
| Street Address |
1969 W HART RD |
| City | BELOIT |
| State | WI |
| Zip Code | 53511 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881681294 | Kenneth L Klein | Physical Medicine & Rehabilitation | 1969 W Hart Rd, Beloit, WI 53511-2230 | 2005-09-30 |
| 1154939924 | Danielle Suzanne Rodriguez | Registered Nurse | 1969 W Hart Rd, Beloit, WI 53511-2230 | 2020-07-17 |
| 1295356020 | Matthew Parish | Pharmacy Technician | 1969 W Hart Rd, Beloit, WI 53511-2230 | 2020-05-04 |
| 1821628082 | Lauren Renee Mueth | Physician Assistant | 1969 W Hart Rd, Beloit, WI 53511-2298 | 2020-01-16 |
| 1477028421 | Chad Schroeder | Physician Assistant | 1969 W Hart Rd, Beloit, WI 53511-2230 | 2018-10-05 |
| 1962988444 | Dawn E Hudson | Social Worker | 1969 W Hart Rd, Beloit, WI 53511-2298 | 2018-07-17 |
| 1316445588 | Doris Vargas | Physician Assistant | 1969 W Hart Rd, Beloit, WI 53511-2230 | 2018-01-23 |
| 1356859508 | Sheila Evanoff | Counselor | 1969 W Hart Rd, Beloit, WI 53511-2230 | 2018-01-22 |
| 1396277844 | Ellen Mary Alice Rippl | Dietitian, Registered | 1969 W Hart Rd, Beloit Memorial Hospital, Beloit, WI 53511-2230 | 2017-04-03 |
| 1356792964 | Nicole Lynn Bengtson | Counselor | 1969 W Hart Rd, Beloit, WI 53511-2230 | 2016-06-24 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730738485 | Linda Lee Cook | Technician | 914 Cranston Rd., Beloit, WI 53511 | 2019-09-05 |
| 1033773734 | Holistic Counseling Services, LLC | Counselor | 1517 Huebbe Parkway, Ste A, Beloit, WI 53511 | 2019-04-28 |
| 1578073870 | Bonita May Cooke | Counselor | 838 Grant St., Beloit, WI 53511 | 2017-10-02 |
| 1679091219 | Stacy Lynn Gallagher | Licensed Practical Nurse | 1060 Bittel St, Beloit, WI 53511 | 2017-09-04 |
| 1629448824 | Brenda Jean Allen | Registered Nurse | 2907 E. Leona Drive, Beloit, WI 53511 | 2015-09-30 |
| 1033595038 | Amber Noel Slaybaugh | Physical Therapist | 838 E. Azalea Ter., Beloit, WI 53511 | 2015-08-03 |
| 1407260326 | Quirt Family Dentistry, Sc | Dentist | 2777 Milwaukee Rd, Beloit, WI 53511 | 2014-06-18 |
| 1821436973 | Raymond K Spade | Counselor | 2240 Prairie Ave., Beloit, WI 53511 | 2013-06-11 |
| 1629321658 | Sarah Ann Nelson | Physical Therapist | 1905 W. Hart Road, Beloit, WI 53511 | 2012-10-15 |
| 1235494212 | Mary Ann Hudson | Nurse Practitioner | 700 College Street, Beloit College, Beloit, WI 53511 | 2012-07-06 |
| Find all providers in zip 53511 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| 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 Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225024300 | Nck Radiology Pa | Radiology | 400 W 8th St, Mitchell County Hospital, Beloit, KS 67420-1605 | 2005-09-23 |
| 1679652689 | Eric J Goth | Radiology | 1969 W Hart Rd, Beloit, WI 53511 | 2006-11-02 |
| 1376563023 | Thomas J Lisk | Radiology | 1969 W Hart Rd, Beloit, WI 53511 | 2006-07-19 |
| 1063430767 | Miguel A Jimenez | Radiology | 1969 W Hart Rd, Beloit, WI 53511 | 2006-07-18 |
| 1487671830 | George Cherian | Radiology | 1969 W Hart Rd, Beloit, WI 53511 | 2006-07-15 |
| 1386661734 | Beloit Radiology Ltd | Radiology | 1969 W Hart Rd, Beloit, WI 53511 | 2006-07-15 |
| 1134115215 | Richard J Kueker | Radiology | 400 W 8th St, Beloit, KS 67420-1605 | 2005-09-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487264511 | Howard Simon Md PC | Radiology | 3960 Hillside Dr Ste 106, Delafield, WI 53018-2148 | 2020-08-04 |
| 1952951154 | Premier Radiology Wisconsin, LLC | Radiology | 10180 Washington Ave Ste 101, Mt Pleasant, WI 53177-1604 | 2019-09-19 |
| 1013478635 | Troy Nelson Tenbrunsel | Radiology | Uw Hospitals & Clinics 600 Highland Road, Madison, WI 53792-0001 | 2019-03-27 |
| 1336660216 | Kevin Shuai Lian | Radiology | 420 W Dayton St Unit 1142, Madison, WI 53703 | 2017-06-30 |
| 1346774726 | Molly Peterson | Radiology | 2639 University Ave Ste 201, Madison, WI 53705-3750 | 2017-04-12 |
| 1821445107 | Ryan Griesbach | Radiology | Uw Hospitals and Clinic, 600 Highland Ave, Madison, WI 53792-0001 | 2016-05-17 |
| 1629442181 | Dysphagia Testing, LLC | Radiology | 10638 Hidden Creek Dr, Mequon, WI 53092-8538 | 2015-11-20 |
| 1679987341 | Daniel Joseph Baumel | Radiology | 513 Clifden Dr, Madison, WI 53711-1530 | 2014-06-20 |
| 1235549247 | Benjamin Sawatzky | Radiology | 9 S Marquette St, Madison, WI 53704-5117 | 2014-04-29 |
| 1285054064 | Matthew Gregory Pipho | Radiology | 9306 Briar Haven Dr, Verona, WI 53593-8791 | 2014-04-21 |
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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.