JONATHAN JAMES MIETCHEN (NPI# 1073030961) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073030961 |
| Entity Type | Individual |
| Full Name | JONATHAN JAMES MIETCHEN |
| Credential | T-LMLP |
| Practice Address |
600 Highland Ave Madison WI 53792-9469 |
| Mailing Address |
7974 Uw Health Ct Middleton WI 53562-5531 |
| Practice Telephone | 6082635430 |
| Enumeration Date | 2017-08-23 |
| Last Update Date | 2020-08-31 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103G00000X | Clinical Neuropsychologist | 3815-57 | WI | Behavioral Health & Social Service Providers |
| N | 103TC0700X |
Psychologist Specialization: Clinical |
2795 | KS | Behavioral Health & Social Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 217 W Ira Ct, Andover, KS 670029469 | 3167335047 |
| Street Address |
600 HIGHLAND AVE |
| City | MADISON |
| State | WI |
| Zip Code | 53792-9469 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336141530 | Michael A Porte | Pediatrics | 600 Highland Ave, Madison, WI 53792-0001 | 2005-06-01 |
| 1922606433 | Catherine Harnois | Radiology | 600 Highland Ave, Madison, WI 53792-0001 | 2020-10-16 |
| 1265039812 | Sara Brown | Nurse Practitioner | 600 Highland Ave, Madison, WI 53792-0001 | 2020-10-07 |
| 1063019602 | Angela Filauro Schroeder | Dietitian, Registered | 600 Highland Ave, Madison, WI 53792-0001 | 2020-10-06 |
| 1134736556 | Kelly A Kopecki | Dietitian, Registered | 600 Highland Ave, Madison, WI 53792-0001 | 2020-09-29 |
| 1699382051 | Megan Elizabeth Grassl | Dietitian, Registered | 600 Highland Ave, Madison, WI 53792-0001 | 2020-09-29 |
| 1568079234 | Michelle Catherine Sawaya | Dietitian, Registered | 600 Highland Ave, Madison, WI 53792-0001 | 2020-09-28 |
| 1417564113 | Megan Severa | Dietitian, Registered | 600 Highland Ave, Madison, WI 53792-0001 | 2020-09-26 |
| 1275140055 | Danielle Knox Alexander | Dietitian, Registered | 600 Highland Ave, Madison, WI 53792-0001 | 2020-09-25 |
| 1427665397 | Kristan O'toole | Dietitian, Registered | 600 Highland Ave, Madison, WI 53792-0001 | 2020-09-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902416969 | Cynthia Iradukunda | Student in an Organized Health Care Education/Training Program | University of Wisconsin School of Medicine and Public H, 600 Highland Ave, B6/319, Madison, WI 53792 | 2020-08-05 |
| 1689162661 | Tseun Han James Kong | Psychiatry & Neurology | Uw Hospitals and Clinics, 600 Highland Ave, Madison, WI 53792 | 2018-04-25 |
| 1194248013 | Kyle Erick Rudningen | Dermatology | Uw Hosptials & Clinics 600 Highland Ave, Madison, WI 53792 | 2017-07-23 |
| 1477083194 | Maxwell Joseph Wingelaar | Ophthalmology | Uw Health University Hospital, Madison, WI 53792 | 2017-06-14 |
| 1790212603 | Imad Khan | Psychiatry & Neurology | Uw Hospitals & Clinics 600 Highland Avenue, Madison, WI 53792 | 2017-05-23 |
| 1700334745 | Krista Lee Rieger | Pharmacist | 600 Higland Avenue, University of Wisconsin Hospital and Clinics, Madison, WI 53792 | 2016-09-20 |
| 1780070086 | Christina Amend | Pediatrics | American Family Childrens Hospital 600 Highland Ave, Madison, WI 53792 | 2015-04-13 |
| 1487040127 | Michelle Stoffel | Pathology | Uw Hospital and Clinics, 600 Highland Ave, Madison, WI 53792 | 2015-04-09 |
| 1417363888 | Jenna Bender | Pharmacist | 600 Highland Avenue, 1530, University of Wisconsin Hospital and Clinics, Madison, WI 53792 | 2014-07-07 |
| 1841619889 | Ying Wang | Psychiatry & Neurology | 600 Highland Ave,h4/831, Uw Hospital and Clinics, Madison, WI 53792 | 2014-04-07 |
| Find all providers in zip 53792 | ||||
| Taxonomy Code | 103G00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Clinical Neuropsychologist |
| An individual with a doctorate degree, licensure in clinical psychology and specialized training or board certification in neuropsychology who practices or adheres to the principles of neuropsychology; a specialty within the field of psychology focusing primarily on neurobehavioral functioning. |
| Notes: Source: American Psychological Association, Washington, DC, 1997. [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295929461 | Laura Palmer Phd LLC | Clinical Neuropsychologist | 37 Kings Rd Ste 102, Madison, NJ 07940-2500 | 2007-08-30 |
| 1255303475 | Bruce P Hermann | Clinical Neuropsychologist | 600 Highland Av, Madison, WI 53792 | 2006-02-02 |
| 1053314344 | Gordon I Herz | Clinical Neuropsychologist | 478 Commerce Dr, Ste 204, Madison, WI 53719-4993 | 2005-05-31 |
| 1538792940 | Gloria M Morel Valdes | Clinical Neuropsychologist | 600 Highland Ave, Madison, WI 53792-0001 | 2020-02-14 |
| 1316580517 | Kelly Nicole Morgan | Clinical Neuropsychologist | 1313 Fish Hatchery Rd, Madison, WI 53715-1911 | 2019-10-21 |
| 1548817935 | John Stratton | Clinical Neuropsychologist | 600 Highland Ave, Madison, WI 53792-0001 | 2019-08-21 |
| 1730640178 | Victoria Jade Williams | Clinical Neuropsychologist | 5249 E Terrace Dr, Madison, WI 53718-8339 | 2019-03-28 |
| 1295216430 | Sarah A Vadnais | Clinical Neuropsychologist | 1313 Fish Hatchery Rd, Madison, WI 53715-1911 | 2018-08-26 |
| 1629519475 | Natalie M Klempel | Clinical Neuropsychologist | 1313 Fish Hatchery Rd, Madison, WI 53715-1911 | 2017-03-13 |
| 1366996928 | Erin Plumley | Clinical Neuropsychologist | 20 S Park St, Madison, WI 53715-1348 | 2016-08-11 |
| Find all providers in MADISON | ||||
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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.