JOHN P. MODRZYNSKI (NPI# 1962475434) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962475434 |
| Entity Type | Individual |
| Full Name | JOHN P. MODRZYNSKI |
| Credential | M.D. |
| Practice Address |
N2934 State Road 22 Wautoma WI 54982-5267 |
| Mailing Address |
122 E College Ave Appleton WI 54911-5794 |
| Practice Telephone | 9207874613 |
| Practice Fax Number | 9207875433 |
| Mailing Telephone | 9207874613 |
| Mailing Fax Number | 9207875433 |
| Enumeration Date | 2006-02-07 |
| Last Update Date | 2018-03-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 23162 | WI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 32833700 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| N2034 Highway 22, Wautoma, WI 54982 | 9207874613 | 9207875433 |
| Street Address |
N2934 STATE ROAD 22 |
| City | WAUTOMA |
| State | WI |
| Zip Code | 54982-5267 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255864963 | Shopko Stores Operating Co., LLC | Durable Medical Equipment & Medical Supplies | N2934 State Road 22, Wautoma, WI 54982-5267 | 2017-04-10 |
| 1548666902 | Erika Niznik | Pharmacist | N2934 State Road 22, Wautoma, WI 54982-5267 | 2014-11-13 |
| 1962817700 | Long Nguyen | Family Medicine | N2934 State Road 22, Wautoma, WI 54982-5267 | 2014-06-30 |
| 1780973826 | Community Health Network | Family Medicine | N2934 State Road 22, Wautoma, WI 54982-5267 | 2011-03-29 |
| 1700195567 | Laura L Baehnman | Nurse Practitioner | N2934 State Road 22, Wautoma, WI 54982-5267 | 2010-09-28 |
| 1417133984 | Eric Foss | Pharmacist | N2934 State Road 22, Wautoma, WI 54982-5267 | 2008-01-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780919506 | Virginia Ellen Moon | Counselor | 203 South 16th Court, Wautoma, WI 54982 | 2009-10-13 |
| 1528232832 | County of Waushara | Public Health or Welfare | 230 W. Park Street, Wautoma, WI 54982 | 2008-04-17 |
| 1770770125 | Waushara County Government | Case Management | 205 W Elm St, Wautoma, WI 54982 | 2007-10-01 |
| 1063606325 | Wautoma Area School District | Local Education Agency (LEA) | 556 S Cambridge St, Wautoma, WI 54982 | 2007-08-30 |
| 1013036433 | David J Brown | Dentist | 400 S Townline Road, Box 1440, Wautoma, WI 54982 | 2007-03-28 |
| 1285773820 | Chiroplus Complementary Healthcare Centers, LLC | Chiropractor | W7841 State Rd 21 &73, Wautoma, WI 54982 | 2007-02-06 |
| 1881767887 | Louis Francis Cooper | Psychologist | W7199 Chicago Road, Wautoma, WI 54982 | 2006-11-16 |
| 1902840069 | Ann E. Moore | Pharmacist | 900 E. Divison St, Aurora Pharmacy #300, Wautoma, WI 54982 | 2006-06-16 |
| 1790737443 | Waushara Industries, Inc. | Non-emergency Medical Transport (VAN) | 210 E Townline Rd, Wautoma, WI 54982 | 2006-05-17 |
| 1164414736 | Kim Ownby | Physician Assistant | N2934 Hwy 22 North, Wautoma, WI 54982 | 2005-08-18 |
| Find all providers in zip 54982 | ||||
| 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 |
|---|---|---|---|---|
| 1386612836 | Timothy R Roberts | Family Medicine | N2934 Highway 22, Wautoma, WI 54982-0650 | 2006-03-10 |
| 1700870607 | Thomas G Chulski | Family Medicine | 900 E Division St, Wautoma, WI 54982-6944 | 2005-09-07 |
| 1427438639 | Horizon Healthcare, Inc. | Family Medicine | 719 W Main St, Wautoma, WI 54982-8503 | 2015-06-03 |
| 1962817700 | Long Nguyen | Family Medicine | N2934 State Road 22, Wautoma, WI 54982-5267 | 2014-06-30 |
| 1780973826 | Community Health Network | Family Medicine | N2934 State Road 22, Wautoma, WI 54982-5267 | 2011-03-29 |
| 1558465633 | David N Crowther | Family Medicine | 900 E Division St, Wautoma, WI 54982 | 2006-09-11 |
| 1437266053 | Gregrey G Hiltgen | Family Medicine | 900 E Division St, Wautoma, WI 54982-6944 | 2006-08-23 |
| 1679581243 | Fozia Sarwar Alvi | Family Medicine | 900 E Division St, Wautoma, WI 54982 | 2006-08-03 |
| 1831117852 | Cheston E Price | Family Medicine | 400 S Townline Rd, Wautoma, WI 54982-6922 | 2006-07-17 |
| 1770575243 | Renee Murphy | Family Medicine | N2934 Hwy 22 North, Wautoma, WI 54982 | 2005-08-19 |
| Find all providers in WAUTOMA | ||||
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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.