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).
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 |
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 |
State | Issuer | Identifier | Type Code |
---|---|---|---|
WI | TRAVELERS RR MEDICARE | CJ6385 | 01 |
WI | 32896900 | 05 |
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 |
Street Address |
13111 N PORT WASHINGTON RD ATTN: RADIATION ONCOLOGY DEPT. |
City | MEQUON |
State | WI |
Zip Code | 53097-2416 |
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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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 Code | 2085R0001X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Radiology |
Specialization | Radiation Oncology |
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 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1558598441 | Eva Christensen | Radiology | 11516 N Port Washington Rd, Mequon, WI 53092-3441 | 2009-06-17 |
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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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.