KIM TAVENER (NPI# 1073994133) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073994133 |
| Entity Type | Individual |
| Full Name | KIM TAVENER |
| Practice Address |
923 Eliza St Green Bay WI 54301-3234 |
| Practice Telephone | 9209654700 |
| Practice Fax Number | 9209654701 |
| Mailing Telephone | 9209654700 |
| Mailing Fax Number | 9209654701 |
| Enumeration Date | 2015-06-15 |
| Last Update Date | 2015-06-15 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 156FX1800X |
Technician/Technologist Specialization: Optician |
Eye and Vision Services Providers |
| Street Address |
923 ELIZA ST |
| City | GREEN BAY |
| State | WI |
| Zip Code | 54301-3234 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710902887 | Kara Jean Rottier | Nurse Practitioner | 923 Eliza St, Green Bay, WI 54301-3234 | 2006-07-12 |
| 1598317265 | Michelle R Schumann | Audiologist | 923 Eliza St, Green Bay, WI 54301-3234 | 2019-07-12 |
| 1518528033 | Cheryl M Robertson | Technician/Technologist | 923 Eliza St, Green Bay, WI 54301-3234 | 2019-06-25 |
| 1962063495 | Christina L Reek | Technician/Technologist | 923 Eliza St, Green Bay, WI 54301-3234 | 2019-06-25 |
| 1265919294 | Lori R Olson | Registered Nurse | 923 Eliza St, Green Bay, WI 54301-3234 | 2018-07-23 |
| 1932565272 | Bellin Memorial Hospital Inc | Audiologist | 923 Eliza St, Green Bay, WI 54301-3234 | 2015-12-31 |
| 1154584035 | Kathryn A Engelhardt | Audiologist | 923 Eliza St, Green Bay, WI 54301-3234 | 2008-07-09 |
| 1770756397 | Judy Winney | Technician/Technologist | 923 Eliza St, Green Bay, WI 54301-3234 | 2008-04-03 |
| 1962675587 | Karen Vandenhouten | Technician/Technologist | 923 Eliza St, Green Bay, WI 54301-3234 | 2008-04-03 |
| 1861691149 | New Ent Sc | Otolaryngology | 923 Eliza St, Green Bay, WI 54301-3234 | 2007-07-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386102465 | Parc Village Dental, LLC | Dentist | 2805 Libal Street, Suite A, Green Bay, WI 54301 | 2019-03-07 |
| 1598229478 | Shaina Marie Conner | Registered Nurse | 835 S Vanburen St, Green Bay, WI 54301 | 2019-01-25 |
| 1093298960 | Brown County | Case Management | 111 N. Jefferson Street, Green Bay, WI 54301 | 2018-09-07 |
| 1639609928 | Frontline Healthcare LLC | Specialist/Technologist, Other | 2221 S. Webster Ave. Suite 270, Greenbay, WI 54301 | 2017-06-19 |
| 1992242606 | Charmaine Rimple | Counselor | 526 South Monroe Avenue, Green Bay, WI 54301 | 2017-01-20 |
| 1962944819 | Rebecca Lucille Reinbold | Registered Nurse | 917 Catherine Street, Green Bay, WI 54301 | 2016-11-09 |
| 1730635061 | Melissa Kristof | Specialist/Technologist, Other | 1821 Sounth Webster Ave., Green Bay, WI 54301 | 2016-08-28 |
| 1255709747 | Vivian Sweetheart Bishop-cook | Counselor | 2920 South Webster Ave, Green Bay, WI 54301 | 2015-09-14 |
| 1881079960 | Chelsi S Weber | Registered Nurse | 2300 Riverside Dr., Ste 204, Green Bay, WI 54301 | 2015-07-30 |
| 1962816371 | Joelle M Hesse | Counselor | 630 Cherry St., Green Bay, WI 54301 | 2014-06-13 |
| Find all providers in zip 54301 | ||||
| Taxonomy Code | 156FX1800X |
| Grouping | Eye and Vision Services Providers |
| Classification | Technician/Technologist |
| Specialization | Optician |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518528033 | Cheryl M Robertson | Technician/Technologist | 923 Eliza St, Green Bay, WI 54301-3234 | 2019-06-25 |
| 1962063495 | Christina L Reek | Technician/Technologist | 923 Eliza St, Green Bay, WI 54301-3234 | 2019-06-25 |
| 1700202538 | America's Best Contacts & Eyeglasses | Technician/Technologist | 1499 W Mason St, Green Bay, WI 54303-2233 | 2014-03-18 |
| 1346525573 | Vision Mart, Inc | Technician/Technologist | 2476 S Oneida St, Suite 105, Green Bay, WI 54304-5289 | 2011-10-19 |
| 1770756397 | Judy Winney | Technician/Technologist | 923 Eliza St, Green Bay, WI 54301-3234 | 2008-04-03 |
| 1962675587 | Karen Vandenhouten | Technician/Technologist | 923 Eliza St, Green Bay, WI 54301-3234 | 2008-04-03 |
| 1558409656 | Wisconsin Vision, Inc. | Technician/Technologist | 2158 W Mason St, Green Bay, WI 54303-4705 | 2007-02-01 |
| 1386727501 | Wal-mart Stores East, Lp | Technician/Technologist | 2440 W Mason St, Green Bay, WI 54303-4711 | 2006-10-23 |
| 1184707309 | Wal-mart Stores East, Lp | Technician/Technologist | 2292 Main St, Green Bay, WI 54311-5307 | 2006-10-23 |
| 1033214275 | Sam's Club Optical | Technician/Technologist | 2470 W Mason St, Green Bay, WI 54303-4711 | 2006-09-13 |
| Find all providers in GREEN BAY | ||||
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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.