HEALTHSTAT ONSITE CLINIC- WAUKESA (NPI# 1174930432) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174930432 |
| Entity Type | Organization |
| Organization Name | HEALTHSTAT ONSITE CLINIC- WAUKESA |
| Practice Address |
615 W Moreland Blvd Waukesha WI 53188-2462 |
| Mailing Address |
4651 Charlotte Park Dr Ste 300 Charlotte NC 28217-1916 |
| Practice Telephone | 7045296161 |
| Enumeration Date | 2014-07-18 |
| Last Update Date | 2014-07-18 |
| Authorized Official Name | WARREN HUTTON (COO) |
| Authorized Official Telephone | 7045296161 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2083P0500X |
Preventive Medicine Specialization: Preventive Medicine/Occupational Environmental Medicine |
Allopathic & Osteopathic Physicians |
| Street Address |
615 W MORELAND BLVD |
| City | WAUKESHA |
| State | WI |
| Zip Code | 53188-2462 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306913801 | Darren James Rausch | Specialist/Technologist, Other | 615 W Moreland Blvd, Waukesha, WI 53188-2462 | 2006-11-29 |
| 1164065876 | Natasha Schultz | Nutritionist | 615 W Moreland Blvd, Waukesha, WI 53188-2462 | 2019-10-25 |
| 1700309911 | Courtney S Handeland | Health Educator | 615 W Moreland Blvd, Waukesha, WI 53188-2462 | 2017-07-19 |
| 1891218053 | Allison Knight | Dietetic Technician, Registered | 615 W Moreland Blvd, Waukesha, WI 53188-2462 | 2017-07-19 |
| 1093140816 | Alysa Blum | Physician Assistant | 615 W Moreland Blvd, Waukesha, WI 53188-2462 | 2013-09-11 |
| 1770847238 | Mary Jo Michels | Dietitian, Registered | 615 W Moreland Blvd, Waukesha, WI 53188-2462 | 2012-06-29 |
| 1093073421 | Carly Chicantek | Registered Nurse | 615 W Moreland Blvd, Waukesha, WI 53188-2462 | 2012-04-23 |
| 1376839134 | Barbara Janet Spain | Technician, Other | 615 W Moreland Blvd, Waukesha, WI 53188-2462 | 2011-06-21 |
| 1003121815 | Ariane Margaret Grudzina | Registered Nurse | 615 W Moreland Blvd, Waukesha, WI 53188-2462 | 2010-08-17 |
| 1518271709 | Jessica Irene Lukas | Technician, Other | 615 W Moreland Blvd, Waukesha, WI 53188-2462 | 2010-07-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336787126 | Nicole Lee Berg-johnson | Nurse Practitioner | 820 Crestwood Dr., Waukesha, WI 53188 | 2019-12-12 |
| 1013475706 | Rachel Mueller | Occupational Therapist | 29667 Summit Ave, S11, Waukesha, WI 53188 | 2019-03-12 |
| 1861962649 | Emily Elizabeth Seefeld | Occupational Therapy Assistant | 29667 Summit Ave S11, Waukesha, WI 53188 | 2018-12-05 |
| 1003393307 | Ashley Susan Callahan | Dental Hygienist | 711 W. Moreland Blvd., Suite 204, Waukesha, WI 53188 | 2018-07-19 |
| 1245741321 | Melissa Weir | Case Manager/Care Coordinator | 514 Riverview Avenue, Waukesha, WI 53188 | 2017-10-17 |
| 1093233629 | Patricia Marie Sombrio | Dental Hygienist | 711 Moreland Blvd 204, Waukesha, WI 53188 | 2017-09-04 |
| 1134660244 | Bdg of Wisconsin, Inc. | Behavioral Analyst | N19w2309 Riverwood Drive, Suite 350 Pmb 314, Waukesha, WI 53188 | 2017-03-09 |
| 1255888731 | Lynne Sarah Alva | Dental Hygienist | 711 Moreland Blvd, Suite 204, Waukesha, WI 53188 | 2016-09-01 |
| 1881069730 | Michelle Koch | Occupational Therapist | 29667 Summit Ave. S11, Waukesha, WI 53188 | 2015-12-03 |
| 1952711012 | Rhonda Schroeder | Dental Hygienist | W286 N991 Shepherds Way, Waukesha, WI 53188 | 2014-04-29 |
| Find all providers in zip 53188 | ||||
| Taxonomy Code | 2083P0500X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Preventive Medicine |
| Specialization | Preventive Medicine/Occupational Environmental Medicine |
| A preventive medicine physician who specializes in preventive medicine/occupational-environmental medicine, which is focused on protecting the population from occupational and environmental conditions. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A General Certificate is issued by the American Osteopathic Board of Preventive Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710950266 | Jean Deuster | Preventive Medicine | 20611 Watertown Rd Ste J, Waukesha, WI 53186-1871 | 2006-02-07 |
| 1497726392 | Joseph Michael Zompa | Preventive Medicine | 3000 N Grandview Blvd, W-685, Waukesha, WI 53188-1615 | 2006-01-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093226144 | Healthstat Onsite Clinic Hsm Sheboygan | Preventive Medicine | 2216 S 24th St, Sheboygan, WI 53081-5548 | 2017-10-17 |
| 1467982751 | Healthstat Onsite Clinic Elmbrook School District | Preventive Medicine | 17000 W North Ave Ste 100e, Brookfield, WI 53005-4454 | 2017-06-19 |
| 1700315033 | Healthstat Onsite Clinic City of Racine | Preventive Medicine | 2333 Northwestern Ave Ste 114, Racine, WI 53404-2520 | 2017-06-09 |
| 1790224780 | Healthstat Onsite Clinic-alm Consolidated | Preventive Medicine | 920 10th Ave N Ste Wellness, Onalaska, WI 54650-2166 | 2017-02-23 |
| 1558805689 | Healthstat Onsite Clinic Alm Holdings | Preventive Medicine | 920 10th Ave N, Onalaska, WI 54650-2166 | 2016-12-08 |
| 1619411733 | Healthstat Onsite Clinic Jj Keller Appleton | Preventive Medicine | 5 Innovation Ct, Appleton, WI 54914-1742 | 2016-12-08 |
| 1851717698 | Carl Zenz | Preventive Medicine | S75w20937 Field Dr, Muskego, WI 53150-8934 | 2014-03-17 |
| 1083640502 | Constantine Dumas | Preventive Medicine | 2009 S Memorial Dr, Appleton, WI 54915-1222 | 2006-06-25 |
| 1568442416 | James Francis Mayr | Preventive Medicine | 8555 West Forest Home Avenue, American Industrial Medical - Suite 205, Greenfield, WI 53228-3408 | 2006-01-18 |
| 1932182177 | Jennifer L Fick | Preventive Medicine | W183s8750 Racine Ave, Muskego, WI 53150-8067 | 2005-11-22 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on HEALTHSTAT ONSITE CLINIC- WAUKESA.
| 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.