TIMOTHY R EDISON (NPI# 1861425902) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861425902 |
| Entity Type | Individual |
| Full Name | TIMOTHY R EDISON |
| Credential | MD |
| Practice Address |
100 Theda Clark Medical Plz Ste 400 Neenah WI 54956-2763 |
| Practice Telephone | 9207254527 |
| Practice Fax Number | 9207292378 |
| Mailing Telephone | 9207254527 |
| Enumeration Date | 2006-07-09 |
| Last Update Date | 2018-10-30 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207RG0100X |
Internal Medicine Specialization: Gastroenterology |
036078276 | IL | Allopathic & Osteopathic Physicians |
| Y | 207RG0100X |
Internal Medicine Specialization: Gastroenterology |
37531 | WI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 32235600 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1550 Midway Pl, Menasha, WI 549521165 | 9207278100 | |
| 2 Transam Plaza Dr, Oakbrook Terrace, IL 601814823 | 6308330653 |
| Street Address |
100 THEDA CLARK MEDICAL PLZ STE 400 |
| City | NEENAH |
| State | WI |
| Zip Code | 54956-2763 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144864356 | Marie K Vanhecke | Nurse Practitioner | 100 Theda Clark Medical Plz Ste 400, Neenah, WI 54956-2763 | 2019-10-30 |
| 1740469881 | Betsy R Winnekens | Surgery | 100 Theda Clark Medical Plz Ste 400, Neenah, WI 54956-2763 | 2007-10-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447768411 | Wisconsin Institute of Surgical Excellence LLC | Clinic/Center | 1265 W American Dr Ste 200, Neenah, WI 54956 | 2018-01-12 |
| 1639614290 | Clinton Robert Murchland | Pharmacist | 828 Fox Point Plaza, Pharmacy, Neenah, WI 54956 | 2017-01-05 |
| 1629448550 | Melissa Christine Hewitt | Physical Therapy Assistant | 1119 Higgins Ave, Neenah, WI 54956 | 2015-10-05 |
| 1437581923 | Ross Phan | Pharmacist | 1432 Seymour Crt, Neenah, WI 54956 | 2013-08-06 |
| 1518201318 | Meridith Nealy Starling | Social Worker | 124 W Wisconsin Ave, Suite 90 B, Neenah, WI 54956 | 2012-11-16 |
| 1639464886 | Wisconsin Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 901 S. Green Bay Rd, Neenah, WI 54956 | 2011-06-16 |
| 1669701439 | Donna Jean Falk | Licensed Practical Nurse | 1037 B Hunt Ave, Neenah, WI 54956 | 2009-12-08 |
| 1285868257 | Angela Marie Bilbrey | Dietitian, Registered | 307 S Commercial St Ste 101, Neenah, WI 54956 | 2009-05-06 |
| 1003083114 | A B See Vision Therapy Centers Sc | Optometrist | 1401 Mcmahon Dr., Suite 100, Neenah, WI 54956 | 2008-05-08 |
| 1629244173 | Tamra Marie Knutson | Radiology | 333 N Commercial St #100, Neenah, WI 54956 | 2008-05-05 |
| Find all providers in zip 54956 | ||||
| Taxonomy Code | 207RG0100X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Gastroenterology |
| An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs. |
| 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 |
|---|---|---|---|---|
| 1306918446 | Swati Chaudhari | Internal Medicine | 130 2nd St, Suite N157, Neenah, WI 54956-2883 | 2006-11-14 |
| 1174692677 | Gastrointestinal Specialists Sc | Internal Medicine | 130 2nd St, Suite N157, Neenah, WI 54956-2883 | 2006-11-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265872998 | Eugene Kligman | Internal Medicine | 13133 N Port Washington Rd Ste G16, Mequon, WI 53097-2423 | 2013-06-26 |
| 1770929226 | Paul Michael Estrada | Internal Medicine | 437 N Frances St, Madison, WI 53703-2013 | 2013-05-10 |
| 1174851273 | Victor Ciofoaia | Internal Medicine | 700 West Ave South, La Crosse, WI 54601 | 2009-12-01 |
| 1255594537 | Freddy Caldera Jr. | Internal Medicine | 1685 Highland Avenue, 4256 Mfcb, Madison, WI 53705 | 2008-07-07 |
| 1457552689 | Erica Ann Samuel | Internal Medicine | 2424 S 90th St Ste 410, West Allis, WI 53227-2455 | 2007-05-28 |
| 1629157425 | Charles Cromwell | Internal Medicine | 2311 N Prospect, Milwaukee, WI 53211 | 2006-11-03 |
| 1992805832 | Suhasini Turlapati | Internal Medicine | 820 E Grant Street, Appleton, WI 54911 | 2006-09-22 |
| 1679676936 | Holy Family Memorial Inc | Internal Medicine | 800 Lakefront Way, Two Rivers, WI 54241-3301 | 2006-09-05 |
| 1639287436 | Kevin A Lang | Internal Medicine | M207 Marsh Ln, Marshfield, WI 54449-9293 | 2006-08-29 |
| 1063423515 | Joel M Carlson | Internal Medicine | 420 Dewey Street, Wisconsin Rapids, WI 54495-0005 | 2006-08-10 |
| 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.