RADIATION ONCOLOGY OF WISCONSIN S C


Address: 13111 N Port Washington Rd, Attn: Radiation Oncology Dept., Mequon, WI 53097-2416
Phone: 2622438384

RADIATION ONCOLOGY OF WISCONSIN S C (NPI# 1164691986) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1164691986
Entity Type Organization
Organization Name RADIATION ONCOLOGY OF WISCONSIN S C
Practice Address 13111 N Port Washington Rd
Attn: Radiation Oncology Dept.
Mequon
WI 53097-2416
Mailing Address Po Box 1127
Sheboygan
WI 53082-1127
Practice Telephone 2622438384
Practice Fax Number 9202438385
Mailing Telephone 9204576750
Mailing Fax Number 9204578350
Enumeration Date 2008-02-26
Last Update Date 2008-04-20
Authorized Official Name CARL E OLSON (MEDICAL DIRECTOR)
Authorized Official Telephone 4142911556
Authorized Official Credential M.D.
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 2085R0203X Radiology
Specialization: Therapeutic Radiology
Allopathic & Osteopathic Physicians
Y 2085R0001X Radiology
Specialization: Radiation Oncology
Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
WI TRAVELERS RR MEDICARE CJ6385 01
WI 32896900 05

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1740271287 Radiation Oncology of Wisconsin S C Radiology 2350 N Lake Dr, Radiation Oncology Dept., Milwaukee, WI 53211-4507 2005-11-03

Office Location

Street Address 13111 N PORT WASHINGTON RD
ATTN: RADIATION ONCOLOGY DEPT.
City MEQUON
State WI
Zip Code 53097-2416

Providers in the same location

NPI Name Taxonomy Address Enumeration
1053360933 Infinity Healthcare Physicians, S.c. Physician Assistant 13111 N Port Washington Rd, Columbia St. Mary's - Ozaukee Campus, Mequon, WI 53097-2416 2006-05-09
1083251631 Abbey Beck Dietitian, Registered 13111 N Port Washington Rd, Mequon, WI 53097-2416 2019-12-03
1184269326 Whitney Gilbert Social Worker 13111 N Port Washington Rd, Mequon, WI 53097-2416 2019-11-12
1831733872 Deidre Alexandra Marsh Social Worker 13111 N Port Washington Rd, Mequon, WI 53097-2416 2019-11-02
1043854474 Elizabeth Shepler Nurse Anesthetist, Certified Registered 13111 N Port Washington Rd, Mequon, WI 53097-2416 2019-10-29
1053952028 Marcus Sojka Physical Therapist 13111 N Port Washington Rd, Mequon, WI 53097-2416 2019-10-01
1740747559 Columbia St Mary's Hospital Ozaukee, Inc. Psychiatric Unit 13111 N Port Washington Rd, Mequon, WI 53097-2416 2019-02-28
1508306671 Philip W Diperna Nurse Practitioner 13111 N Port Washington Rd, Mequon, WI 53097-2416 2017-03-08
1932652732 Karen Neusen Occupational Therapist 13111 N Port Washington Rd, Mequon, WI 53097-2416 2016-07-27
1255796181 Magdalena Walentynowicz Physician Assistant 13111 N Port Washington Rd, Mequon, WI 53097-2416 2015-12-18
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1851512982 Wendy S Balister Dietitian, Registered 13111 North Port Washington Rd, Mequon, WV 53097 2007-05-02
1902985922 Lisa Lang Counselor 14135 North Cedarburg Road, Mequon, WI 53097 2006-11-02
1003915570 Joan T Gnadt Internal Medicine 13133 N Port Washington Rd., Suite 111, Mequon, WI 53097 2006-09-21
1255439097 Susan J Riegg Pathology 13111 N Port Washington Road, Mequon, WI 53097 2006-09-20
1891808887 Gregory Eric Custer Dentist 13615 N Cedarburg Road, Mequon, WI 53097 2006-08-16
1114958600 Richard K Karr Orthopaedic Surgery 13133n Port Washington Road, #216, Mequon, WI 53097 2006-07-05
1548204712 Lauretta Lyon Schears Occupational Therapist 13111 N. Portwashington Rd, Mequon, WI 53097 2006-06-16
1235173337 Sarah Marie Neman Physical Therapy Assistant 13111 N Prot Washington Rd., Mequon, WI 53097 2006-06-16
1538103643 Elizabeth Gral Sullivan Speech-Language Pathologist 13111 North Port Washington Road, Mequon, WI 53097 2006-06-16
1952808701 Lisa Lang LLC Counselor 14135 North Cedarburg Road, Mequon, WI 53097 2018-04-09
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Taxonomy Information

Taxonomy Code 2085R0001X
Grouping Allopathic & Osteopathic Physicians
Classification Radiology
Specialization Radiation Oncology

Taxonomy Definition

A radiologist who deals with the therapeutic applications of radiant energy and its modifiers and the study and management of disease, especially malignant tumors.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source]
- Additional Resources: American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1558598441 Eva Christensen Radiology 11516 N Port Washington Rd, Mequon, WI 53092-3441 2009-06-17

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1922652510 Sangjune Lee Radiology 710 Ridge St Apt 207, Madison, WI 53705-3641 2019-07-31
1225456981 John Martin Floberg Radiology 2140, Med 4 Mailbox, Hslc, 750 Highland Ave., Madison, WI 53705 2014-03-31
1669815569 Joshua Knute Elson Radiology 6811 118th Ave, Kenosha, WI 53142 2013-04-10
1154651727 Matthew Edward Witek Radiology 309 W Johnson St Apt 714, Madison, WI 53703-3553 2010-01-05
1265687024 Marcia Js Richards Radiology 675 Park Cir, Elm Grove, WI 53122-2556 2008-11-20
1891888269 Michael E Ray Radiology 900 E Grant, Appleton, WI 54911-3487 2006-09-30
1093759185 Editha A Krueger Radiology 424 E Wisconsin Ave, Appleton, WI 54911-4860 2006-06-16
1336187251 Laura B Ulmer Radiology 3809 Spring St, Racine, WI 53405-1667 2006-06-03
1558318782 Linda Gemer Radiology 1277 Hickory Hill Dr, Green Bay, WI 54304-2363 2006-05-31
1609822774 Darryl R Barton Radiology 215 N 28th Ave, Wausau, WI 54401-4100 2006-05-26
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Competitor

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City MEQUON
Zip Code 53097

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Dataset Information

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.

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