CAROLYN SHANNON SMITH (NPI# 1902965965) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902965965 |
| Entity Type | Individual |
| Full Name | CAROLYN SHANNON SMITH |
| Credential | M.D. |
| Practice Address |
545 N 15th St Milwaukee WI 53233-2237 |
| Mailing Address |
240 W Indian Creek Ct Milwaukee WI 53217-2323 |
| Practice Telephone | 4142887184 |
| Mailing Telephone | 4145406593 |
| Enumeration Date | 2006-12-06 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207QS0010X |
Family Medicine Specialization: Sports Medicine |
38125 | WI | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245889773 | Carolyn Dianne Smith | Technician | 14077 Felton Rd, Gulfport, MS 39503-5131 | 2019-09-06 |
| 1225521917 | Carolyn Ann Smith | Home Health Aide | 13755 New Halls Ferry Rd, Florissant, MO 63033-3028 | 2018-06-07 |
| 1164911079 | Carolyn J Smith | Behavior Technician | 306 S Mason St, Bensenville, IL 60106-2682 | 2018-05-07 |
| 1174062319 | Carolyn Diane Smith | Registered Nurse | 2305 Springhill Ln, Lindenhurst, IL 60046-8326 | 2017-02-21 |
| 1538539580 | Carolyn Smith | Counselor | 13919 Carrollwood Village Run, Tampa, FL 33618-2746 | 2015-10-02 |
| 1649657230 | Carolyn Marian Smith | Nurse Practitioner | 1000 Morris Ave # Dn-126a, Union, NJ 07083-7133 | 2015-05-03 |
| 1962646786 | Carolyn Marion Smith | Clinic/Center | 3620 N Lauren Ln, Bloomington, IN 47404-9206 | 2009-04-23 |
| 1124226824 | Carolyn M Smith | Pharmacist | 43 Sabin St Quad Bldg Rm Qe 213, Charleston, SC 29245 | 2007-07-05 |
| 1750585063 | Carolyn R Smith | Nurse Practitioner | 326 South Side Road, Bee Branch, AR 72013-9137 | 2007-06-12 |
| 1154538460 | Carolyn Smith | Case Manager/Care Coordinator | 1500 Kanakanak Road, Dillingham, AK 99576-0310 | 2007-05-17 |
| Street Address |
545 N 15TH ST |
| City | MILWAUKEE |
| State | WI |
| Zip Code | 53233-2237 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497707152 | Brandt M Mylott | Pediatrics | 545 N 15th St, Milwaukee, WI 53233-2237 | 2006-05-17 |
| 1932236726 | Student Health Service | Clinic/Center | 545 N 15th St, Marquette University, Milwaukee, WI 53201-1881 | 2007-02-27 |
| 1881776458 | Robin Brown | Internal Medicine | 545 N 15th St, Milwaukee, WI 53233-2237 | 2006-10-20 |
| 1174605356 | James Carl Schabla | Physician Assistant | 545 N 15th St, Milwaukee, WI 53233-2237 | 2006-10-19 |
| 1750473567 | Ann Bennett Schoper | Physician Assistant | 545 N 15th St, Milwaukee, WI 53233-2237 | 2006-09-29 |
| 1114962230 | Keli R Wollmer | Physician Assistant | 545 N 15th St, Milwaukee, WI 53233-2237 | 2006-06-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104454750 | Henok Desta Hardilo | Student in an Organized Health Care Education/Training Program | Aurora Sinai Medical Center 945 N 12th Street, Milwaukee, WI 53233 | 2020-03-30 |
| 1821633314 | Ann E Millard | Occupational Therapist | 560 N. 16th Street, Room 214a, Milwaukee, WI 53233 | 2019-11-08 |
| 1306480918 | Teng Kai Ong | Dentist | 1801 West Wisconsin Ave., Milwaukee, WI 53233 | 2019-11-06 |
| 1356800478 | Nebiyu Abera Tilahun | Student in an Organized Health Care Education/Training Program | Aurora Sinai Medical Center, 945 N. 12th Street, Milwaukee, WI 53233 | 2019-03-18 |
| 1548748387 | Emily Claire Goetz | Physical Therapist | 945 N. 12th St. Suite 1100, Milwaukee, WI 53233 | 2018-08-03 |
| 1801373378 | Froedtert & The Medical College of Wisconsin Community Physicians | Non-Pharmacy Dispensing Site | 1721 W Canal St, Milwaukee, WI 53233 | 2018-07-26 |
| 1184170706 | Lauren Troll | Physical Therapist | 925 N 12th Street, Milwaukee, WI 53233 | 2016-09-01 |
| 1942694401 | Iryna Nemesh | Internal Medicine | 1020 N 12th St Fl 2, Milwaukee, WI 53233 | 2015-03-23 |
| 1649676032 | Matina Angelopoulou | Dentist | 1801 West Winsconsin Ave, Milwaukee, WI 53233 | 2014-11-12 |
| 1780007831 | John Ladisa | Technician, Other | 1637 W. Wisconsin Ave, Room 311, Milwaukee, WI 53233 | 2014-01-27 |
| Find all providers in zip 53233 | ||||
| Taxonomy Code | 207QS0010X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Specialization | Sports Medicine |
| A family medicine physician that is trained to be responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention of injury and illness. A sports medicine physician must have knowledge and experience in the promotion of wellness and the prevention of injury. Knowledge about special areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation, injuries (treatment and prevention and referral practice) and the role of exercise in promoting a healthy lifestyle are essential to the practice of sports medicine. The sports medicine physician requires special education to provide the knowledge to improve the health care of the individual engaged in physical exercise (sports) whether as an individual or in team participation. |
| 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 Family Medicine, 2007. http://www.theabfm.org/. American Osteopathic Board of Family Medicine, 2007. http://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 Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790858462 | Shanyn Colleen Lancaster | Family Medicine | 1250 W Wisconsin Ave, Student Health, Schroeder Complex, Lower Level, Milwaukee, WI 53233-2225 | 2006-11-17 |
| 1215989579 | Craig C Young | Family Medicine | 8700 W Watertown Plank Rd, Wisconsin Athletic Club Building, Milwaukee, WI 53226-3595 | 2006-05-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811203706 | Matthew M Brown | Family Medicine | 1705 Hoffman St, Madison, WI 53704-2510 | 2010-08-30 |
| 1174764906 | Mark W Niedfeldt, Md, LLC | Family Medicine | 10556 N Port Washington Rd, Ste 101, Mequon, WI 53092-5586 | 2009-03-06 |
| 1225151558 | Patrick Earl Mcdonough | Family Medicine | 235 State Street, St. Croix Falls, WI 54024 | 2007-04-10 |
| 1306919907 | Steven Alan Giles | Family Medicine | 3316 Ridgeline Dr, Waukesha, WI 53188 | 2006-11-15 |
| 1689220527 | Delo Sport and Stem Sc | Family Medicine | 2595 Development Dr Ste 140, Green Bay, WI 54311-4267 | 2019-08-15 |
| 1417377755 | Todd Domeyer | Family Medicine | 3113 Saemann Ave, Sheboygan, WI 53081 | 2014-04-25 |
| 1972949501 | Chad Joseph Giles | Family Medicine | 4100 State Highway 66, Stevens Point, WI 54482 | 2013-05-22 |
| 1073956363 | Lucianne Helena Olewinski | Family Medicine | Uw Hospital and Clinics, 600 Highland Ave, Madison, WI 53792-0001 | 2013-04-17 |
| 1902166978 | Jessica L Juntunen | Family Medicine | 5200 Hummingbird Rd, Suite 100, Wausau, WI 54401-6312 | 2012-05-23 |
| 1255607057 | John Charles Pick-jacobs | Family Medicine | 7401 104th Ave Ste 110, Kenosha, WI 53142 | 2012-03-26 |
| 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.