JOHN DAVID BIVINS II (NPI# 1841230463) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1841230463 |
| Entity Type | Individual |
| Full Name | JOHN DAVID BIVINS II |
| Credential | M.D. |
| Practice Address |
12800 N Port Washington Rd Mequon WI 53097-2415 |
| Mailing Address |
4425 N Port Washington Rd Attn: Csmcp Clinic Credentialing Glendale WI 53212-1082 |
| Practice Telephone | 2622439600 |
| Practice Fax Number | 2622439661 |
| Mailing Telephone | 4145419900 |
| Mailing Fax Number | 4145466790 |
| Enumeration Date | 2006-06-08 |
| Last Update Date | 2012-06-04 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 45682-020 | WI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 34417600 | 05 |
| Street Address |
12800 N PORT WASHINGTON RD |
| City | MEQUON |
| State | WI |
| Zip Code | 53097-2415 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538690292 | Melissa M Grube | Family Medicine | 12800 N Port Washington Rd, Mequon, WI 53097-2415 | 2017-03-24 |
| 1740469741 | Tracie M Dunek | Family Medicine | 12800 N Port Washington Rd, Mequon, WI 53097-2415 | 2007-10-26 |
| 1053338632 | Henry J Schnitzler Jr. | Family Medicine | 12800 N Port Washington Rd, Mequon, WI 53097-2415 | 2006-07-17 |
| 1730105750 | Linda Tampa | Family Medicine | 12800 N Port Washington Rd, Mequon, WI 53097-2415 | 2006-07-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851512982 | Wendy S Balister | Dietitian, Registered | 13111 North Port Washington Rd, Mequon, WV 53097 | 2007-05-02 |
| 1902985922 | Lisa Lang | Counselor | 14135 North Cedarburg Road, Mequon, WI 53097 | 2006-11-02 |
| 1003915570 | Joan T Gnadt | Internal Medicine | 13133 N Port Washington Rd., Suite 111, Mequon, WI 53097 | 2006-09-21 |
| 1255439097 | Susan J Riegg | Pathology | 13111 N Port Washington Road, Mequon, WI 53097 | 2006-09-20 |
| 1891808887 | Gregory Eric Custer | Dentist | 13615 N Cedarburg Road, Mequon, WI 53097 | 2006-08-16 |
| 1114958600 | Richard K Karr | Orthopaedic Surgery | 13133n Port Washington Road, #216, Mequon, WI 53097 | 2006-07-05 |
| 1548204712 | Lauretta Lyon Schears | Occupational Therapist | 13111 N. Portwashington Rd, Mequon, WI 53097 | 2006-06-16 |
| 1235173337 | Sarah Marie Neman | Physical Therapy Assistant | 13111 N Prot Washington Rd., Mequon, WI 53097 | 2006-06-16 |
| 1538103643 | Elizabeth Gral Sullivan | Speech-Language Pathologist | 13111 North Port Washington Road, Mequon, WI 53097 | 2006-06-16 |
| 1952808701 | Lisa Lang LLC | Counselor | 14135 North Cedarburg Road, Mequon, WI 53097 | 2018-04-09 |
| Find all providers in zip 53097 | ||||
| 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 |
|---|---|---|---|---|
| 1336227834 | Jeffrey T Sabatino | Family Medicine | 11725 N Port Washington Rd, Ste 250, Mequon, WI 53092-3485 | 2006-11-01 |
| 1326050436 | Nicola M. Charlton | Family Medicine | 11221 N Parkview Dr, Mequon, WI 53092-1923 | 2006-08-13 |
| 1316979552 | John J Yang | Family Medicine | 6425 W Mequon Road, Mequon, WI 53092 | 2006-07-07 |
| 1205887775 | Mark W Niedfeldt | Family Medicine | 10556 North Port Washington Road, Suite 101, Mequon, WI 53092-5586 | 2006-05-12 |
| 1639131998 | Paul J Mankus | Family Medicine | 10219 N Trillium Rd, Mequon, WI 53092-6174 | 2006-04-03 |
| 1306819305 | Richard Lewis | Family Medicine | 11649 N Port Washington Rd Ste 114, Your Md, Sc., Mequon, WI 53092-3461 | 2006-02-09 |
| 1598742652 | Michael Gerard | Family Medicine | 11430 N Port Washington Rd, Mequon, WI 53092-3414 | 2005-12-29 |
| 1144797614 | Ovation Hand Institute, LLC | Family Medicine | 10532 N Port Washington Rd, Mequon, WI 53092-5563 | 2018-11-01 |
| 1174018584 | Ashley A Mcguire | Family Medicine | 12203 Corporate Pkwy, Mequon, WI 53092 | 2018-06-27 |
| 1588173199 | Kelly Payne Smith | Family Medicine | 10554 N Port Washington Rd, Mequon, WI 53092-5537 | 2017-09-26 |
| Find all providers in MEQUON | ||||
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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.