MRS. KIM MARIE SHEFCHIK (NPI# 1174547244) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174547244 |
| Entity Type | Individual |
| Full Name | MRS. KIM MARIE SHEFCHIK |
| Other Name | KIM DALEBROUX |
| Credential | PA-C |
| Practice Address |
704 S Webster Ave Ste. 300 Green Bay WI 54301-3528 |
| Mailing Address |
Po Box 22487 Green Bay WI 54305-2487 |
| Practice Telephone | 9204683444 |
| Practice Fax Number | 9204326313 |
| Mailing Telephone | 9204457226 |
| Mailing Fax Number | 9204457229 |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2019-12-06 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 1484 | WI | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 32400300 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1630 Commanche Ave, Green Bay, WI 543135753 | 9204304700 | 9204304747 |
| 720 S Vanburen St Suite 101, Green Bay, WI 543013504 | 9204333420 | 9203386859 |
| Street Address |
704 S WEBSTER AVE STE. 300 |
| City | GREEN BAY |
| State | WI |
| Zip Code | 54301-3528 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932102787 | Pamela C Baeten | Internal Medicine | 704 S Webster Ave, Ste 500, Green Bay, WI 54301-3528 | 2005-05-24 |
| 1164959680 | Cynthia L Suplinski | Nurse Practitioner | 704 S Webster Ave, Green Bay, WI 54301-3528 | 2017-05-15 |
| 1073063681 | Bellin Memorial Hospital Inc | Internal Medicine | 704 S Webster Ave, Suite 501, Green Bay, WI 54301-3528 | 2016-10-06 |
| 1265986731 | Susan Molenaar | Nurse Practitioner | 704 S Webster Ave, Green Bay, WI 54301-3528 | 2016-08-12 |
| 1225403157 | Bonnie L Dejardin | Nurse Practitioner | 704 S Webster Ave, Green Bay, WI 54301-3528 | 2015-12-03 |
| 1437531720 | Bellin Memorial Hospital Inc | Obstetrics & Gynecology | 704 S Webster Ave, Suite 100 A, Green Bay, WI 54301-3533 | 2015-06-23 |
| 1841672516 | Bellin Memorial Hospital Inc | Obstetrics & Gynecology | 704 S Webster Ave, Suite 100 B, Green Bay, WI 54301-3533 | 2015-06-18 |
| 1407295389 | Michael Chistopher Popelars | Dentist | 704 S Webster Ave, Suite 402, Green Bay, WI 54301-3528 | 2013-06-24 |
| 1013350958 | New Dermatology Group Ltd | Dermatology | 704 S Webster Ave, Green Bay, WI 54301-3528 | 2013-04-10 |
| 1235444225 | Melissa A Anderson | Nurse Practitioner | 704 S Webster Ave, Suite 300, Green Bay, WI 54301-3528 | 2010-08-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386102465 | Parc Village Dental, LLC | Dentist | 2805 Libal Street, Suite A, Green Bay, WI 54301 | 2019-03-07 |
| 1598229478 | Shaina Marie Conner | Registered Nurse | 835 S Vanburen St, Green Bay, WI 54301 | 2019-01-25 |
| 1093298960 | Brown County | Case Management | 111 N. Jefferson Street, Green Bay, WI 54301 | 2018-09-07 |
| 1639609928 | Frontline Healthcare LLC | Specialist/Technologist, Other | 2221 S. Webster Ave. Suite 270, Greenbay, WI 54301 | 2017-06-19 |
| 1992242606 | Charmaine Rimple | Counselor | 526 South Monroe Avenue, Green Bay, WI 54301 | 2017-01-20 |
| 1962944819 | Rebecca Lucille Reinbold | Registered Nurse | 917 Catherine Street, Green Bay, WI 54301 | 2016-11-09 |
| 1730635061 | Melissa Kristof | Specialist/Technologist, Other | 1821 Sounth Webster Ave., Green Bay, WI 54301 | 2016-08-28 |
| 1255709747 | Vivian Sweetheart Bishop-cook | Counselor | 2920 South Webster Ave, Green Bay, WI 54301 | 2015-09-14 |
| 1881079960 | Chelsi S Weber | Registered Nurse | 2300 Riverside Dr., Ste 204, Green Bay, WI 54301 | 2015-07-30 |
| 1962816371 | Joelle M Hesse | Counselor | 630 Cherry St., Green Bay, WI 54301 | 2014-06-13 |
| Find all providers in zip 54301 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700253101 | Mathias Dahnert | Physician Assistant | 945 S Irwin Ave, Green Bay, WI 54301-3309 | 2015-09-01 |
| 1770992067 | Sheila M Teddy | Physician Assistant | 2595 Development Dr Ste 150, Green Bay, WI 54311-4288 | 2014-08-12 |
| 1245652718 | Bailey Bauer | Physician Assistant | 2753 Mayline Dr, Green Bay, WI 54311-9646 | 2014-01-17 |
| 1588949333 | Carissa Ann Coorough | Physician Assistant | 720 S Van Buren St Ste 301, Green Bay, WI 54301-3534 | 2011-10-12 |
| 1093942047 | Taresa B Fassbender | Physician Assistant | 3263 Eaton Rd Ste 1, Green Bay, WI 54311-6830 | 2009-06-17 |
| 1265628507 | Colleen M Van Egeren | Physician Assistant | 715 Superior Rd, Suite 120, Green Bay, WI 54311-7594 | 2007-09-20 |
| 1427079516 | Dermatology Clinic S.c. | Physician Assistant | 715 Superior Rd Ste 120, Green Bay, WI 54311-7595 | 2006-07-22 |
| 1316976814 | Kevin F Nelson | Physician Assistant | 3237 Voyager Dr, Green Bay, WI 54311-8349 | 2006-06-30 |
| 1841233186 | Randall R Southards | Physician Assistant | 2845 Greenbrier Rd Ste 320, Green Bay, WI 54311-6519 | 2006-06-14 |
| 1285684662 | Elaine M Smith | Physician Assistant | 301 Bay Park Sq, Green Bay, WI 54304-5104 | 2006-05-10 |
| Find all providers in GREEN BAY | ||||
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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.