DR. MICHAEL J KELLUM (NPI# 1164599387) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164599387 |
| Entity Type | Individual |
| Full Name | DR. MICHAEL J KELLUM |
| Credential | MD |
| Practice Address |
W9575 Homburg Lane Whitewater WI 53190 |
| Mailing Address |
W9675 Homburg Ln Whitewater WI 53190-3702 |
| Practice Telephone | 2624730961 |
| Mailing Telephone | 2624730961 |
| Enumeration Date | 2006-11-30 |
| Last Update Date | 2015-07-24 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207P00000X | Emergency Medicine | 36138-020 | WI | Allopathic & Osteopathic Physicians |
| N | 207PE0004X |
Emergency Medicine Specialization: Emergency Medical Services |
36138-020 | WI | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376591032 | Michael W Kellum | Family Medicine | 1105 Central Expy N, Ste. 110, Allen, TX 75013-6103 | 2006-05-05 |
| Street Address |
W9575 HOMBURG LANE |
| City | WHITEWATER |
| State | WI |
| Zip Code | 53190 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962908608 | Shannon Bashor | Specialist/Technologist | 907 W Schwager Dr, Whitewater, WI 53190 | 2018-04-02 |
| 1922542695 | Terry Teipner | Counselor | 1173 W Main St Ste B, Whitewater, WI 53190 | 2016-12-14 |
| 1063800100 | Courtney Stefanski | Specialist/Technologist | 900 Schwager Drive, Whitewater, WI 53190 | 2014-12-23 |
| 1275942989 | Courtney Palubicki | Specialist/Technologist | 907 W. Schwager Drive, Whitewater, WI 53190 | 2014-08-06 |
| 1548491087 | Ann Marie Welch | Registered Nurse | 9640 N. County Line Rd, Whitewater, WI 53190 | 2009-07-31 |
| 1780801423 | Marsha Lee Mckinnon | Registered Nurse | 710 Starin Road, Whitewater, WI 53190 | 2007-04-20 |
| 1861596371 | Brian William Veale | Chiropractor | 543 S Putnam St, Whitewater, WI 53190 | 2006-09-13 |
| 1629508908 | Erin Kae Clark | Specialist/Technologist | 800 W Main St, Williams Center 105g, Whitewater, WI 53190 | 2017-06-19 |
| 1952854150 | Rebecca K Hamman | Nurse Practitioner | 710 W Starin Rd, Whitewater, WI 53190 | 2016-07-25 |
| 1063859197 | Casey Diane Sidders | Dentist | 1515 W Main St, Whitewater, WI 53190 | 2013-05-30 |
| Find all providers in zip 53190 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518128065 | James J Tydrich | Emergency Medicine | 351 S Wisconsin St Unit 4, Whitewater, WI 53190-2078 | 2008-06-18 |
| 1770633042 | Sean P.l.p. Alwin | Emergency Medicine | 1305 W Main St, Whitewater, WI 53190-1503 | 2007-01-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275012171 | Kathleen Ray Price | Emergency Medicine | 146 Old Orchard Ln, Neenah, WI 54956-4954 | 2018-08-10 |
| 1043730690 | Jonathan Weseman | Emergency Medicine | 3003 University Dr, Marinette, Marinette, WI 54143 | 2017-06-25 |
| 1780115634 | Sean Anthony Mackman | Emergency Medicine | 9200 W Wisconsin Ave # 1p, Milwaukee, WI 53226-3522 | 2017-03-22 |
| 1114375367 | Arthur How Jen Chiu | Emergency Medicine | 1726 Chadbourne Ave, Madison, WI 53726-4108 | 2016-05-28 |
| 1912352873 | Glenn Thiel | Emergency Medicine | N20015 Echo Lake Rd, Niagra, WI 54151 | 2016-04-28 |
| 1437512613 | Jacob Tyler Clark | Emergency Medicine | 1035 Kepler Dr, Green Bay, WI 54311-8320 | 2016-04-04 |
| 1639532526 | Rinal Patel | Emergency Medicine | 9200 W Loomis Rd Ste 212, Franklin, WI 53132 | 2016-03-30 |
| 1871955187 | Scott Erickson | Emergency Medicine | 4876 N Sheffield Ave, Whitefish Bay, WI 53217-5962 | 2016-03-25 |
| 1992166821 | Nicholas W Hawley | Emergency Medicine | 3003 W Good Hope Rd # Bcm320, Milwaukee, WI 53209-2042 | 2016-03-20 |
| 1164802138 | Adam Nicholson | Emergency Medicine | 600 Highlanc Ave, Madison, WI 53792-0001 | 2015-06-04 |
| Find all providers with the same taxonomy | ||||
| City | WHITEWATER |
| Zip Code | 53190 |
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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.