KELLY JANELL FEHRENBACHER (NPI# 1831157114) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831157114 |
| Entity Type | Individual |
| Full Name | KELLY JANELL FEHRENBACHER |
| Credential | MD |
| Practice Address |
1111 W Wisconsin St Sparta WI 54656-2233 |
| Mailing Address |
1836 South Ave La Crosse WI 54601-5429 |
| Practice Telephone | 6082696731 |
| Mailing Telephone | 6087827300 |
| Enumeration Date | 2006-05-03 |
| Last Update Date | 2020-01-24 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RG0300X |
Internal Medicine Specialization: Geriatric Medicine |
48684-20 | WI | Allopathic & Osteopathic Physicians |
| N | 207RH0002X |
Internal Medicine Specialization: Hospice and Palliative Medicine |
48684 | WI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 1831157114 | 05 | |
| WI | MERCYCARE INSURANCE | FEHREKEL | 01 |
| WI | BCBSWI | 1831157114 | 01 |
| Street Address |
1111 W WISCONSIN ST |
| City | SPARTA |
| State | WI |
| Zip Code | 54656-2233 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932104114 | Jon M Williamson | Optometrist | 1111 W Wisconsin St, Sparta, WI 54656-2233 | 2005-06-15 |
| 1972001881 | Carmen Alyssa Adams | Physician Assistant | 1111 W Wisconsin St, Sparta, WI 54656 | 2018-01-25 |
| 1912439639 | Christopher J Tookey | Family Medicine | 1111 W Wisconsin St, Sparta, WI 54656-2233 | 2017-03-31 |
| 1962943084 | Ashley Stalter | Counselor | 1111 W Wisconsin St, Sparta, WI 54656-2233 | 2017-03-09 |
| 1659823839 | Taneshia Michelle Wilson | Counselor | 1111 W Wisconsin St, Sparta, WI 54656 | 2016-11-03 |
| 1326395195 | Krysta Ann Bever | Physical Therapist | 1111 W Wisconsin St, Sparta, WI 54656 | 2012-08-10 |
| 1912228859 | Candace M Hundt | Physical Therapist | 1111 W Wisconsin St, Sparta, WI 54656-2233 | 2010-06-15 |
| 1619158151 | Donna Jean Kettner | Social Worker | 1111 W Wisconsin St, Sparta, WI 54656-2233 | 2007-11-26 |
| 1235171836 | Gundersen Clinic, Ltd. | Clinic/Center | 1111 W Wisconsin St, Sparta, WI 54656 | 2006-06-11 |
| 1578518346 | Gundersen Clinic, Ltd. | Clinic/Center | 1111 W Wisconsin St, Sparta, WI 54656 | 2006-05-23 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669929279 | Jennifer Johnson | Physical Therapy Assistant | 14345 County Hwy B, Sparta, WI 54656 | 2016-09-01 |
| 1578019899 | M&t Performance Chiropractic, LLC | Chiropractor | 213 N Black River St, Sparta, WI 54656 | 2016-08-28 |
| 1801223003 | Emily M Nolte | Counselor | 112 S Court St. Room 3000, Sparta, WI 54656 | 2013-10-02 |
| 1518254945 | Therapeutic Home Services | Point of Service | 9484 Festival Avenue, Sparta, WI 54656 | 2011-07-06 |
| 1639488273 | Rebecca Ann Frey | Reflexologist | 5680 Canary Ave, Sparta, WI 54656 | 2010-09-30 |
| 1316276660 | Gary J Korthals | Pharmacist | 201 S. Water St, Sparta, WI 54656 | 2009-12-16 |
| 1689847329 | Donald N. La Force | Hearing Instrument Specialist | 117 West Oak St, Sparta, WI 54656 | 2008-04-02 |
| 1164400503 | Alice M Bachop | Nurse Practitioner | 310 West Main Street, Sparta, WI 54656 | 2006-01-05 |
| 1578540894 | Marc D Tumerman | Family Medicine | 310 West Main St, Sparta, WI 54656 | 2005-12-28 |
| 1003398488 | Ariel Dawn Ferdock | Pharmacist | 310 W Main St, Sparta, WI 54656 | 2018-09-03 |
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| Taxonomy Code | 207RG0300X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Geriatric Medicine |
| An internist who has special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes and the hospital. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437390028 | Michigan Medical Patient Care | Internal Medicine | 65 Ida Red Ave, Sparta, MI 49345-1735 | 2009-03-12 |
| 1184934226 | Spectrum Health Primary Care Partners | Internal Medicine | 65 Ida Red Ave, Sparta, MI 49345-1735 | 2010-10-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487015301 | Louis Harvey Frase | Internal Medicine | 2516 E Princeton Ave, Eau Claire, WI 54703-4133 | 2016-03-20 |
| 1588045702 | Maureen Bruns | Internal Medicine | 3054 Maple Grove Dr, Madison, WI 53719-1912 | 2015-06-12 |
| 1952554966 | William Jerold Hisgen | Internal Medicine | 1215 Garfield St, 1215 Garfield St., Madison, WI 53711-2215 | 2008-11-04 |
| 1114005642 | Ahmet U. Demircioglu | Internal Medicine | 2000 E Layton Ave Ste 170, St Francis, WI 53235-6055 | 2006-11-01 |
| 1235229568 | Mary Parish Gavinski | Internal Medicine | 205 Bishops Way, Brookfield, WI 53005-6247 | 2006-10-16 |
| 1831200781 | In-your-home Medicine & Geriatrics | Internal Medicine | 3915 N Ridgefield Cir, Shorewood, WI 53211-2451 | 2006-08-31 |
| 1376653261 | Paul Joseph Drinkt | Internal Medicine | N2665 County Rd Qq, Wisconsin Veterans Home, King, WI 54946 | 2006-08-30 |
| 1003882994 | Soryal A Soryal | Internal Medicine | 1020 N 12th St, 3rd Floor, Milwaukee, WI 53233-1308 | 2006-02-28 |
| 1467439729 | Kanwardeep Singh | Internal Medicine | 1155 N Honey Creek Pkwy, Wauwatosa, WI 53213-3189 | 2005-12-28 |
| 1528674801 | Pai Participant 23 Sc | Internal Medicine | 1475 Birch Hill Ln, Shawano, WI 54166-3707 | 2020-09-22 |
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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.