EDWARD T STEVENS MD SC (NPI# 1962521716) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962521716 |
| Entity Type | Organization |
| Organization Name | EDWARD T STEVENS MD SC |
| Practice Address |
600 52nd Street Suite 240 Kenosha WI 53140-3423 |
| Practice Telephone | 2626560006 |
| Practice Fax Number | 2626560005 |
| Mailing Telephone | 2626560006 |
| Mailing Fax Number | 2626560005 |
| Enumeration Date | 2007-03-29 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. EDWARD TERRANCE STEVENS (PRESIDENT) |
| Authorized Official Telephone | 2626560006 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
22919020 | WI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 30305400 | 05 |
| Street Address |
600 52ND STREET SUITE 240 |
| City | KENOSHA |
| State | WI |
| Zip Code | 53140-3423 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225663396 | Lydia Zopf | Counselor | 2001 Alford Park Dr., Carthage College, Kenosha, WI 53140 | 2020-03-09 |
| 1952949406 | Rotate Rehabilitation and Performance | Physical Therapist | 5606 6th Avenue Suite Ll9, Kenosha, WI 53140 | 2019-12-16 |
| 1134778590 | Brenda Chiapetta | Registered Nurse | 3233 23rd Ave, Kenosha, WI 53140 | 2019-09-09 |
| 1275003394 | Kimberly Shaffner | Family Medicine | 4536 22nd Avenue, Kenosha, WI 53140 | 2018-12-01 |
| 1659863389 | Bart L Mengo | Contractor | 1715 60th Street, Kenosha, WI 53140 | 2018-05-30 |
| 1093182941 | Guided Wellness Counseling | Community/Behavioral Health | 1112 56th St, Kenosha, WI 53140 | 2015-08-26 |
| 1376970764 | Stacey L Andersen | Acupuncturist | 5603 7th Ave, Kenosha, WI 53140 | 2013-10-01 |
| 1841467438 | Deborah Schwerdtfeger | Occupational Therapy Assistant | 3415 Sheridan Road, Woodstock Rehab Dept, Kenosha, WI 53140 | 2008-05-13 |
| 1942492020 | Rebecca Ann Burdette | Counselor | 920 60th Street, Renosha, WI 53140 | 2007-08-13 |
| 1851598619 | Aurora Medical Group, Inc. | Durable Medical Equipment & Medical Supplies | 2707 15th Place, Kenosha, WI 53140 | 2007-06-27 |
| Find all providers in zip 53140 | ||||
| Taxonomy Code | 2084N0400X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Neurology |
| A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144327792 | Neurology Center of Kenosha, S.c. | Psychiatry & Neurology | 704 55th St, Kenosha, WI 53140-3732 | 2006-09-17 |
| 1316277130 | Saritha Kundoor | Psychiatry & Neurology | 10400 75th St, Kenosha, WI 53142-7884 | 2009-12-29 |
| 1649406893 | Consultants In Neurology, Sc | Psychiatry & Neurology | 3601 30th Ave, Suite 201, Kenosha, WI 53144-1695 | 2009-06-02 |
| 1629258132 | Mary L. Campagna-gibson | Psychiatry & Neurology | 6308 8th Ave, Suite 2000, Kenosha, WI 53143-5031 | 2007-11-13 |
| 1831388990 | Amit Ray | Psychiatry & Neurology | 10400 75th St, Kenosha, WI 53142-7884 | 2007-10-15 |
| 1932310661 | Elena Korniychuk | Psychiatry & Neurology | 10400 75th St, Suite 315, Kenosha, WI 53142-7884 | 2007-05-24 |
| 1811032378 | Herb George Roehrich | Psychiatry & Neurology | 920 60th St, Kenosha, WI 53140-4041 | 2007-02-21 |
| 1871564013 | Leonid Bouinyi | Psychiatry & Neurology | 6308 8th Ave, Suite 2000, Kenosha, WI 53143-5031 | 2006-01-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689162661 | Tseun Han James Kong | Psychiatry & Neurology | Uw Hospitals and Clinics, 600 Highland Ave, Madison, WI 53792 | 2018-04-25 |
| 1235630625 | The Cervical Spine Institute and Neuromonitoring, LLC | Psychiatry & Neurology | 2221 S Webster Ave # 268, Green Bay, WI 54301-2158 | 2018-02-22 |
| 1235647793 | Midwest Monitoring, LLC | Psychiatry & Neurology | 4321 W College Ave Ste 200, Appleton, WI 54914 | 2018-01-18 |
| 1477937274 | Baycare Clinic LLP | Psychiatry & Neurology | 4801 Expo Drive, Manitowoc, WI 54220 | 2015-07-13 |
| 1184011975 | Abdulrahim Ismail | Psychiatry & Neurology | 3003 University Dr Ste 203, Marinette, WI 54143-4110 | 2015-04-20 |
| 1033505821 | Heydi Flores Podadera | Psychiatry & Neurology | 721 N Midvale Blvd, Madison, WI 53705-3233 | 2015-04-08 |
| 1104221092 | Sharon Anne Bremer | Psychiatry & Neurology | 423 Landimore Ln, Wales, WI 53183-9552 | 2014-11-04 |
| 1891120093 | Robert T Schmidt Jr. | Psychiatry & Neurology | 2460 Old Plank Rd, De Pere, WI 54115-8658 | 2013-09-06 |
| 1356656771 | Klasinski Neurocare, Sc | Psychiatry & Neurology | 500 Vincent St Ste B, Stevens Point, WI 54481-1842 | 2010-08-10 |
| 1497931661 | Audrey Jantzen | Psychiatry & Neurology | 1685 Highland Ave, Department of Neurology - Centennial Building, Madison, WI 53705-2281 | 2008-01-17 |
| 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.