JUSTIN GABRIEL HARTKE (NPI# 1154689685) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154689685 |
| Entity Type | Individual |
| Full Name | JUSTIN GABRIEL HARTKE |
| Credential | M.D. |
| Practice Address |
411 Westwood Dr Wausau WI 54401 |
| Mailing Address |
411 Westwood Dr Wausau WI 54401-4152 |
| Practice Telephone | 7158472558 |
| Practice Fax Number | 7158472557 |
| Mailing Telephone | 7158472558 |
| Mailing Fax Number | 7158472557 |
| Enumeration Date | 2012-05-03 |
| Last Update Date | 2018-07-03 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RG0100X |
Internal Medicine Specialization: Gastroenterology |
69359-20 | WI | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
411 WESTWOOD DR |
| City | WAUSAU |
| State | WI |
| Zip Code | 54401 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104821651 | Michael J Hein | Nurse Anesthetist, Certified Registered | 411 Westwood Dr, Wausau, WI 54401-4152 | 2005-06-20 |
| 1932548112 | Breanna T Wentland | Physician Assistant | 411 Westwood Dr, Wausau, WI 54401-4152 | 2013-06-20 |
| 1104164417 | Marissa J Hernandez | Nurse Anesthetist, Certified Registered | 411 Westwood Dr, Wausau, WI 54401 | 2013-01-21 |
| 1932465523 | Adam Christopher Godsey | Internal Medicine | 411 Westwood Dr, Wausau, WI 54401-4152 | 2012-04-08 |
| 1063788503 | Melinda Rae Wayde | Internal Medicine | 411 Westwood Dr, Wausau, WI 54401-4152 | 2012-03-29 |
| 1871880591 | Laura M. Van Ryn | Physician Assistant | 411 Westwood Dr, Wausau, WI 54401-4152 | 2011-07-01 |
| 1619108743 | Laura B Schlund | Nurse Practitioner | 411 Westwood Dr, Wausau, WI 54401-4152 | 2009-08-06 |
| 1962663559 | Gastrointestinal Associates Endoscopy Center, LLC | Clinic/Center | 411 Westwood Dr, Wausau, WI 54401 | 2008-06-17 |
| 1154504538 | Veronika Gagovic | Internal Medicine | 411 Westwood Dr, Wausau, WI 54401-4152 | 2007-12-09 |
| 1760546949 | Gastrointestinal Associates S.c. | Internal Medicine | 411 Westwood Dr, Wausau, WI 54401-4152 | 2006-12-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164031464 | Central Wisconsin Endodontic Specialists LLC | Dentist | 2606 Stewart Avenue, #102, Wausau, WI 54401 | 2020-07-23 |
| 1376161976 | Family Foot and Ankle Clinic LLC | Podiatrist | 1901 Westwood Boulevard, Wausau, WI 54401 | 2020-07-09 |
| 1336701895 | Amy Kluetz | Counselor | 3000 Westhill Drive, Suite 100, Wausau, WI 54401 | 2019-07-05 |
| 1437640877 | Joseph T Fitz | Student in an Organized Health Care Education/Training Program | Aspirus Wausau Family Medicine, 425 Wind Ridge Drive, Wausau, WI 54401 | 2018-05-22 |
| 1699293241 | Amanda Nedd | Dietitian, Registered | 425 Pine Ridge Boulevard Suite 220 C, Wausau, WI 54401 | 2017-09-05 |
| 1396287447 | Dee Cha | Nurse Anesthetist, Certified Registered | 4851 Rachel Ln Apt 5, Wausau, WI 54401 | 2016-11-07 |
| 1013389618 | Grace Lutheran Foundation Inc | Skilled Nursing Facility | 2727 Plaza Dr., Wausau, WI 54401 | 2015-10-22 |
| 1881091163 | Judy Lao | Dental Hygienist | 413 North 17th Avenue, Wausau, WI 54401 | 2014-12-02 |
| 1295012011 | Allison Waraksa | Pharmacist | 504 S. 17th Ave, Wausau, WI 54401 | 2011-11-08 |
| 1881974053 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 504 S 17th Ave, Wausau, WI 54401 | 2011-08-19 |
| Find all providers in zip 54401 | ||||
| Taxonomy Code | 207RG0100X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Gastroenterology |
| An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932465523 | Adam Christopher Godsey | Internal Medicine | 411 Westwood Dr, Wausau, WI 54401-4152 | 2012-04-08 |
| 1063788503 | Melinda Rae Wayde | Internal Medicine | 411 Westwood Dr, Wausau, WI 54401-4152 | 2012-03-29 |
| 1265628317 | Gi Consult, Sc | Internal Medicine | 1506 Pine View Ln, Wausau, WI 54403-2361 | 2007-09-22 |
| 1760546949 | Gastrointestinal Associates S.c. | Internal Medicine | 411 Westwood Dr, Wausau, WI 54401-4152 | 2006-12-21 |
| 1952475931 | Raymond L Hartke | Internal Medicine | 411 Westwood Dr, Wausau, WI 54401-4152 | 2006-11-20 |
| 1740354745 | James R Schlais | Internal Medicine | 411 Westwood Dr, Wausau, WI 54401-4152 | 2006-11-20 |
| 1609940725 | Christopher A Young | Internal Medicine | 411 Westwood Dr, Wausau, WI 54401-4152 | 2006-11-20 |
| 1982778700 | Benjamin Michael Schneeberger | Internal Medicine | 411 Westwood Dr, Wausau, WI 54401-4152 | 2006-11-20 |
| 1245276534 | Eric A. Johnson | Internal Medicine | 411 Westwood Dr, Wausau, WI 54401-4152 | 2006-06-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265872998 | Eugene Kligman | Internal Medicine | 13133 N Port Washington Rd Ste G16, Mequon, WI 53097-2423 | 2013-06-26 |
| 1770929226 | Paul Michael Estrada | Internal Medicine | 437 N Frances St, Madison, WI 53703-2013 | 2013-05-10 |
| 1174851273 | Victor Ciofoaia | Internal Medicine | 700 West Ave South, La Crosse, WI 54601 | 2009-12-01 |
| 1255594537 | Freddy Caldera Jr. | Internal Medicine | 1685 Highland Avenue, 4256 Mfcb, Madison, WI 53705 | 2008-07-07 |
| 1457552689 | Erica Ann Samuel | Internal Medicine | 2424 S 90th St Ste 410, West Allis, WI 53227-2455 | 2007-05-28 |
| 1629157425 | Charles Cromwell | Internal Medicine | 2311 N Prospect, Milwaukee, WI 53211 | 2006-11-03 |
| 1992805832 | Suhasini Turlapati | Internal Medicine | 820 E Grant Street, Appleton, WI 54911 | 2006-09-22 |
| 1679676936 | Holy Family Memorial Inc | Internal Medicine | 800 Lakefront Way, Two Rivers, WI 54241-3301 | 2006-09-05 |
| 1639287436 | Kevin A Lang | Internal Medicine | M207 Marsh Ln, Marshfield, WI 54449-9293 | 2006-08-29 |
| 1063423515 | Joel M Carlson | Internal Medicine | 420 Dewey Street, Wisconsin Rapids, WI 54495-0005 | 2006-08-10 |
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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.