Derek E Clevidence (NPI# 1093774135, PAC ID# 1759435951) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is FAMILY MEDICINE.
| Nation Provider ID (NPI) | 1093774135 |
| PAC ID by PECOS | 1759435951 |
| Professional Enrollment ID | I20090824000159 |
| Full Name | Derek E Clevidence |
| Organization Legal Name | MERITER HOSPITAL, INC |
| Address |
100 Silverado Dr Stoughton WI 53589-5406 |
| Phone Number | 6084178700 |
| Gender | M |
| Medical School | UNIVERSITY OF ILLINOIS AT CHICAGO HEALTH SCIENCE CENTER |
| Graduation Year | 1997 |
| Primary Specialty | FAMILY MEDICINE |
| Group Practice PAC ID | 3971412735 |
| Number of Group Practice Members | 131 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 520089 | MERITER HOSPITAL |
| 520098 | UNIVERSITY OF WI HOSPITALS & CLINICS AUTHORITY |
| Address | Phone | Organization |
|---|---|---|
| 202 S Park St, Madison, WI 53715-1507 | 6084176000 | MERITER HOSPITAL, INC |
| 6408 Copps Ave, Monona, WI 53716-3702 | 6084173000 | MERITER HOSPITAL, INC |
| 100 Silverado Dr, Stoughton, WI 53589-5406 | 6084178700 | MERITER HOSPITAL, INC |
| Organization Legal Name | MERITER HOSPITAL, INC |
| Physicians | 140 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Megan Rose Foss | Nurse Practitioner | Meriter Hospital, Inc | 345 W Washington Ave, Suite 100, Madison, WI 53703-2996 |
| Sara K. Marshall | Nurse Practitioner | Meriter Hospital, Inc | 6408 Copps Ave, Monona, WI 53716-3702 |
| Monica Harms | Nurse Practitioner | Meriter Hospital, Inc | 2601 W Beltline Hwy, Suite 200, Madison, WI 53713-2319 |
| Ioana Huibregtse | Nurse Practitioner | Meriter Hospital, Inc | 7780 Elmwood Ave, Suite 201, Middleton, WI 53562-5407 |
| James H Shropshire | Family Medicine | Meriter Hospital, Inc | 2690 Reaserch Park Dr F, Fitchburg, WI 53711-4921 |
| Paul H Hinderaker | Cardiovascular Disease (cardiology) | Meriter Hospital, Inc | 800 Clay St, Darlington, WI 53530-1228 |
| Mon Yee | Family Medicine | Meriter Hospital, Inc | 4200 Savannah Dr, De Forest, WI 53532-2909 |
| R Compton Kurtz Ii | Family Medicine | Meriter Hospital, Inc | 202 S Park St, Madison, WI 53715-1507 |
| N Thomas Casper | Internal Medicine | Meriter Hospital, Inc | 202 S Park St, Madison, WI 53715-1507 |
| Karen L Stammer | Internal Medicine | Meriter Hospital, Inc | 202 S Park St, Madison, WI 53715-1507 |
| Street Address |
100 SILVERADO DR |
| City | STOUGHTON |
| State | WI |
| Zip | 53589-5406 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Kimberly A Moreland | Nurse Practitioner | Meriter Hospital, Inc | 100 Silverado Dr, Stoughton, WI 53589-5406 |
| Mary C Ball | Family Medicine | Meriter Hospital, Inc | 100 Silverado Dr, Stoughton, WI 53589-5406 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Jason L Guerin | Chiropractic | Zelm Chiropractic Center Sc | 798 Hwy 51 E, Stoughton, WI 53589 |
| Clare Tillman Kuehl | Nurse Practitioner | Dean Health Systems Inc | 225 Church St, Stoughton, WI 53589-1801 |
| Cory A Fields | Optometry | Dean Health Systems Inc | 225 Church St, Stoughton, WI 53589-1801 |
| Leslie L Adams | Nurse Practitioner | Dean Health Systems Inc | 225 Church St, Stoughton, WI 53589-1801 |
| Daniel J Staddler | Family Medicine | Dean Health Systems Inc | 225 Church St, Stoughton, WI 53589-1801 |
| Laura G Ozkan | Physician Assistant | Dean Health Systems Inc | 225 Church St, Stoughton, WI 53589-1801 |
| Pamela S Mahaffey | Nurse Practitioner | Dean Health Systems Inc | 225 Church St, Stoughton, WI 53589-1801 |
| Laura D Stolcpart | Family Medicine | Dean Health Systems Inc | 225 Church St, Stoughton, WI 53589-1801 |
| Lea Anne Schomisch Novy | Physician Assistant | Dean Health Systems Inc | 225 Church St, Stoughton, WI 53589-1801 |
| Dean G Kresge | Family Medicine | Dean Health Systems Inc | 225 Church St, Stoughton, WI 53589-1801 |
| Find all physicians in zip 53589 | |||
| City | STOUGHTON |
| Zip Code | 53589 |
| Specialty | FAMILY MEDICINE |
| City + Specialty | STOUGHTON + FAMILY MEDICINE |
Please comment or provide details below to improve the information on Derek E Clevidence.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.