WHITEFISH BAY FOOT & ANKLE CLINC, LLC (NPI# 1003909847) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003909847 |
| Entity Type | Organization |
| Organization Name | WHITEFISH BAY FOOT & ANKLE CLINC, LLC |
| Practice Address |
155 E Silver Spring Dr Ste 205 Whitefish Bay WI 53217-4704 |
| Mailing Address |
Po Box 11430 Milwaukee WI 53211-0430 |
| Practice Telephone | 4149671900 |
| Practice Fax Number | 4149671926 |
| Mailing Telephone | 4149629070 |
| Mailing Fax Number | 4149629050 |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2008-03-10 |
| Authorized Official Name | JASON BOUDREAU (PODIATRIST / OWNER) |
| Authorized Official Telephone | 4149671900 |
| Authorized Official Credential | DP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
Podiatric Medicine & Surgery Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 43266800 | 05 |
| Street Address |
155 E SILVER SPRING DR STE 205 |
| City | WHITEFISH BAY |
| State | WI |
| Zip Code | 53217-4704 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922632587 | Jasmine Dockery | Pharmacist | 5400 N Port Washington, Glendale, WI 53217 | 2020-02-23 |
| 1174017339 | North Lakes Nursing Home Health Care Agency LLC | Home Health | 225 E Fairmount Ave, Milwaukee, WI 53217 | 2018-06-20 |
| 1083140289 | Miriah Ann King, Ms, Lpc | Counselor | 7805 North Boyd Way, Fox Point, WI 53217 | 2017-05-08 |
| 1245783067 | Lakesha L Jones | Counselor | 5235 N Ironwood Rd, Glendale, WI 53217 | 2016-07-28 |
| 1750783312 | Ibrahim S Abouzeid | Specialist/Technologist, Other | 333 W Brown Deer Road, #240, Milwaukee, WI 53217 | 2014-09-25 |
| 1255733598 | Victoria Gorodetsky | Pharmacist | 229 W Indian Creek Ct, Milwaukee, WI 53217 | 2014-09-18 |
| 1174800049 | John Herman Esser | Internal Medicine | 1050 W Acacia Rd, Milwaukee, WI 53217 | 2011-11-07 |
| 1710298351 | Leann M Harman | Physical Therapist | 5333 N Port Washington Rd Ste B, Glendale, WI 53217 | 2010-06-29 |
| 1306012455 | Emily Marie Gallagher | Speech-Language Pathologist | 6700 N. Port Washington Road, Milwaukee, WI 53217 | 2008-05-07 |
| 1164625455 | Mary Catherine Enderlin | Psychologist | 6110 N Port Washington Road, The Cambridge Group, Glendale, WI 53217 | 2007-06-06 |
| Find all providers in zip 53217 | ||||
| Taxonomy Code | 213ES0103X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| Specialization | Foot & Ankle Surgery |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225675697 | Grayco LLC | Podiatrist | 7128 Tamarack Ct, Mequon, WI 53092-8517 | 2019-12-04 |
| 1124688114 | Foot Factor Podiatry LLC | Podiatrist | 6125 Green Bay Rd Ste 600, Kenosha, WI 53142-2928 | 2019-06-20 |
| 1063928752 | Sheboygan Foot Care, LLC | Podiatrist | 630 Riverfront Dr Ste 202, Sheboygan, WI 53081-4616 | 2017-12-18 |
| 1295279461 | Colin T Graney | Podiatrist | 664 W. Washington Ave, Madison, WI 53703 | 2016-12-07 |
| 1790158368 | Wisconsin Visiting Podiatry | Podiatrist | 28606 Sandpiper Trl, Waterford, WI 53185-1733 | 2015-11-04 |
| 1225415540 | Alexander Blaschke | Podiatrist | 1009 Caledonia St, La Crosse, WI 54603 | 2015-05-06 |
| 1164861712 | Jessica Leigh Minder | Podiatrist | W62n179 Washington Ave Ste 3, Cedarburg, WI 53012-2770 | 2013-06-17 |
| 1326322884 | Northwoods Foot & Ankle LLC | Podiatrist | 1400 Us Highway 51 N, Unit G, Arbor Vitae, WI 54568-9504 | 2011-10-03 |
| 1336434075 | James David Torhorst | Podiatrist | 1439 Churchill St # 202, Waupaca, WI 54981-2089 | 2011-06-10 |
| 1154632412 | Anton John Sella | Podiatrist | 2835 N Grandview Blvd Ste 300, Pewaukee, WI 53072-5591 | 2010-07-01 |
| Find all providers with the same taxonomy | ||||
| City | WHITEFISH BAY |
| Zip Code | 53217 |
Please comment or provide details below to improve the information on WHITEFISH BAY FOOT & ANKLE CLINC, LLC.
| 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.