MITCH D. POPPENS (NPI# 1144207879) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144207879 |
| Entity Type | Individual |
| Full Name | MITCH D. POPPENS |
| Credential | PA-C |
| Practice Address |
323 Sw 10th St Madison SD 57042-3200 |
| Practice Telephone | 6052566551 |
| Practice Fax Number | 6052566469 |
| Mailing Telephone | 6052566551 |
| Mailing Fax Number | 6052566469 |
| Enumeration Date | 2005-12-23 |
| Last Update Date | 2017-02-21 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
0522 | SD | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SD | 6824594 | 05 |
| Street Address |
323 SW 10TH ST |
| City | MADISON |
| State | SD |
| Zip Code | 57042-3200 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508843327 | Wayne A Wetzbarger | Internal Medicine | 323 Sw 10th St, Madison, SD 57042-3200 | 2005-12-22 |
| 1194339614 | Emily Spanier | Physician Assistant | 323 Sw 10th St, Madison, SD 57042-3200 | 2020-09-02 |
| 1245796770 | Paul Bindert | Physical Therapist | 323 Sw 10th St, Madison, SD 57042-3200 | 2019-02-20 |
| 1154898971 | Jordan Elisabeth Eichacker | Dietitian, Registered | 323 Sw 10th St, Madison, SD 57042-3200 | 2018-10-30 |
| 1619461290 | Heather Hagberg | Speech-Language Pathologist | 323 Sw 10th St, Madison, SD 57042-3200 | 2018-06-18 |
| 1073971321 | Jackie Joanne Bau | Nurse Practitioner | 323 Sw 10th St, Madison, SD 57042-3200 | 2016-02-02 |
| 1568839983 | Lewis Drugs, Inc. | Pharmacy | 323 Sw 10th St, Suite 101, Madison, SD 57042 | 2015-09-02 |
| 1114336153 | Meggan Leigh Reisch | Registered Nurse | 323 Sw 10th St, Madison, SD 57042-3200 | 2014-08-04 |
| 1750624177 | Laura Hoefert | Family Medicine | 323 Sw 10th St, Madison, SD 57042-3200 | 2013-04-03 |
| 1326301128 | Ben Liscano | Family Medicine | 323 Sw 10th St, Madison, SD 57042-3200 | 2012-06-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316493042 | Renae Christensen | Psychologist | 820 N. Washington Ave., Madison, SD 57042 | 2016-09-01 |
| 1275080889 | Lance Koenig | Psychologist | 820 North Washington Ave, Plec Dakota State University, Madison, SD 57042 | 2016-09-01 |
| 1699145532 | Counseling Associates, Alla Jones | Counselor | 726 S. Washington Ave., Madison, SD 57042 | 2015-10-05 |
| 1619222080 | Laura Elizabeth Larsen | Occupational Therapist | 917 North Washington, Madison, SD 57042 | 2012-07-20 |
| 1639470925 | Jessica Rogers | Physical Therapy Assistant | 416 South Harth Ave., Madison, SD 57042 | 2010-11-03 |
| 1093924169 | Bradley Dale Gilbert | Specialist/Technologist | 1302 N Washington Ave, Madison, SD 57042 | 2007-05-22 |
| 1659420073 | Every Citizen Counts Organization | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 706 Sw 7th St, Madison, SD 57042 | 2007-01-09 |
| 1912076985 | Larry Paul Green Sr. | Dentist | 102 N Egan Ave, Madison, SD 57042 | 2006-11-06 |
| 1306854062 | Michael Steven Brooke | Optometrist | 302 N Harth Avenue, Madison, SD 57042 | 2006-08-04 |
| 1336118181 | Douglas J Caron | Chiropractor | 120 Nw 2nd St, Madison, SD 57042 | 2006-03-15 |
| Find all providers in zip 57042 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962804211 | Miranda Street Sudduth | Physician Assistant | 1607 Doctors Drive, Madison, MS 39110 | 2014-09-18 |
| 1184944068 | Thomas Harvey Greene IIi | Physician Assistant | 248 Ne Hancock Ave, Madison, FL 32340-2560 | 2010-06-02 |
| 1699001735 | Chad Jamison Gilliam | Physician Assistant | 1230 Slaughter Rd Ste C, Madison, AL 35758-5901 | 2009-10-24 |
| 1679763700 | Tamara A Melone | Physician Assistant | 2802 International Lane, Madison, WI 53708-0017 | 2007-07-25 |
| 1932237138 | Craig Michael Roberts | Physician Assistant | 2631 Chamberlain Ave, Madison, WI 53705-3717 | 2007-03-01 |
| 1639234610 | Sally-ann P Johannsen | Physician Assistant | 717 Hidden Cave Rd, Madison, WI 53717-2755 | 2006-12-27 |
| 1023105467 | Nicole Anna Hanson | Physician Assistant | 1617 Sherman Avenue, Madison, WI 53708-0017 | 2006-10-06 |
| 1730137548 | Renee A Knutson | Physician Assistant | 38 Hidden Hollow Trl, Madison, WI 53717-2501 | 2006-05-04 |
| 1669439329 | Deanna J Nakada | Physician Assistant | 750 University Row, Madison, WI 53705-1311 | 2006-04-27 |
| 1326002213 | Angela K Vitcenda | Physician Assistant | 701 Dane Street, Madison, WI 53713 | 2006-04-17 |
| 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.