JONATHAN E KIECHLE (NPI# 1083903512) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083903512 |
| Entity Type | Individual |
| Full Name | JONATHAN E KIECHLE |
| Practice Address |
2424 S 90th St West Allis WI 53227 |
| Mailing Address |
2424 S 90th St West Allis WI 53227-2455 |
| Practice Telephone | 4146491280 |
| Mailing Telephone | 4146491280 |
| Enumeration Date | 2011-04-05 |
| Last Update Date | 2019-08-22 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208800000X | Urology | 68601 | WI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 100079599 | 05 |
| Street Address |
2424 S 90TH ST |
| City | WEST ALLIS |
| State | WI |
| Zip Code | 53227 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811999063 | Richard D Davenport | Ophthalmology | 2424 S 90th St, Ste 506, West Allis, WI 53227-2455 | 2005-06-01 |
| 1881227205 | Sirr Grice | Pharmacist | 2424 S 90th St, West Allis, WI 53227-2455 | 2020-02-13 |
| 1730673955 | Denine Eva Anagnoustopolous | Physician Assistant | 2424 S 90th St, West Allis, WI 53227 | 2018-06-20 |
| 1881133593 | Jason R Gehring | Nurse Practitioner | 2424 S 90th St, West Allis, WI 53227-2455 | 2017-02-14 |
| 1265975825 | Rachel A Lewis | Nurse Practitioner | 2424 S 90th St, West Allis, WI 53227-2455 | 2016-11-29 |
| 1750737367 | Michael Goshorn | Family Medicine | 2424 S 90th St, West Allis, WI 53227-2455 | 2016-05-12 |
| 1366810020 | Kathleen J Krickeberg | Nurse Practitioner | 2424 S 90th St, West Allis, WI 53227-2455 | 2015-09-10 |
| 1568867232 | Lee David Klemens | Registered Nurse | 2424 S 90th St, Suite 504, West Allis, WI 53227-2455 | 2014-10-23 |
| 1578999405 | Kathleen Conrad | Pharmacist | 2424 S 90th St, West Allis, WI 53227-2455 | 2013-09-24 |
| 1538594585 | Aurora Advanced Healthcare, Inc. | Durable Medical Equipment & Medical Supplies | 2424 S 90th St, Suite 500, West Allis, WI 53227-2455 | 2013-09-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205451564 | Ginger Renee Bland | Nurse Practitioner | 11133 W. National Avenue, West Allis, WI 53227 | 2020-06-12 |
| 1003312141 | Dynamic Medical Equipment, LLC | Durable Medical Equipment & Medical Supplies | 10236 W National Ave, West Allis, WI 53227 | 2018-04-05 |
| 1932572641 | Alissa Kristine Walker | Specialist/Technologist | 11601 W Lincoln Ave, West Allis, WI 53227 | 2015-11-03 |
| 1396155990 | Bradly Earl Helinski | Physical Therapy Assistant | 3023 S 84th St., Milwaukee, WI 53227 | 2014-05-05 |
| 1609299783 | Amy Renee Rozumalski | Occupational Therapy Assistant | 10150 W. National Ave, Suite 150, Premiere Medical Staffing Services, LLC, Milwaukee, WI 53227 | 2014-01-27 |
| 1497098438 | Kathleen Marie Schneider | Physical Therapy Assistant | 3023 S. 84th Street, Milwaukee, WI 53227 | 2013-03-28 |
| 1760723373 | Lee Ann Schraith | Physical Therapy Assistant | 3023 S. 84th St, Milwaukee, WI 53227 | 2013-03-06 |
| 1740520725 | Samantha Lynn Wozniak | Physical Therapist | 3023 S. 84th St., Milwaukee, WI 53227 | 2013-02-27 |
| 1831434901 | Andrew Paul Roeder | Physical Therapy Assistant | 3023 S. 89th Street, Milwaukee, WI 53227 | 2012-11-30 |
| 1538418116 | Christine Wilford | Social Worker | 2044 S 96th Street, West Allis, WI 53227 | 2012-08-29 |
| Find all providers in zip 53227 | ||||
| Taxonomy Code | 208800000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Urology |
| A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Urology, 2007. http://www.abu.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Urology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730445255 | Anand Patel | Urology | 2424 S 90th St Fl 3, West Allis, WI 53227-2455 | 2012-04-10 |
| 1407899552 | William H Annesley Jr. | Urology | 11211 W Lincoln Ave, Lincoln Avenue Clinic, West Allis, WI 53227-1035 | 2006-06-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649520180 | George Leonard Apfelbach Jr. | Urology | 4098 Main St, Fish Creek, WI 54212-0067 | 2012-09-12 |
| 1346505708 | Kenneth Lowell Day | Urology | 2603 Teal Ave (residence), Wausau, WI 54401-7162 | 2012-07-11 |
| 1356601587 | Fox Valley Urological Associates Sc | Urology | 2700 E Enterprise Ave Ste A, Appleton, WI 54913-7656 | 2012-05-22 |
| 1831486117 | Mary Hallman Leikness | Urology | 358 S. Oxford Street, Pob 207, Wautoma, WI 54982-0000 | 2011-07-07 |
| 1710293105 | Charles Copland Smith | Urology | 674 Sunset Circle, Green Bay, WI 54301 | 2010-08-24 |
| 1689991200 | Sean Brady Mcadams | Urology | 720 S Vanburen Street, Suite 301, Green Bay, WI 54301 | 2010-04-21 |
| 1730404385 | Robert J Hartman Jr. | Urology | 10400 75th St Ste 204, Kenosha, WI 53142-7884 | 2010-04-06 |
| 1588998538 | Gary Melvin Licklider | Urology | 5002 Prairie Rose Ct, Middleton, WI 53562-2385 | 2009-09-23 |
| 1376793240 | Raymond Harkavy | Urology | 9440 N. Broadmoor Road, Milwaukee, WI 53217-1309 | 2008-09-26 |
| 1356591978 | Randle E Pollard | Urology | 1233 N. Marshall St., #274, Milwaukee, WI 53202 | 2008-09-19 |
| Find all providers with the same taxonomy | ||||
| City | WEST ALLIS |
| Zip Code | 53227 |
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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.