MELISSA FAUBERT (NPI# 1194137026) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194137026 |
| Entity Type | Individual |
| Full Name | MELISSA FAUBERT |
| Credential | D.O. |
| Practice Address |
2817 New Pinery Rd Portage WI 53901 |
| Mailing Address |
2817 New Pinery Rd Portage WI 53901-9240 |
| Practice Telephone | 6087454598 |
| Practice Fax Number | 6087456393 |
| Mailing Telephone | 6087454598 |
| Mailing Fax Number | 6087456393 |
| Enumeration Date | 2014-05-27 |
| Last Update Date | 2018-07-09 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | 036.143132 | IL | Allopathic & Osteopathic Physicians |
| Y | 207QS0010X |
Family Medicine Specialization: Sports Medicine |
69524-21 | WI | Allopathic & Osteopathic Physicians |
| Street Address |
2817 NEW PINERY RD |
| City | PORTAGE |
| State | WI |
| Zip Code | 53901 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174506307 | James T Gariti Sr. | Emergency Medicine | 2817 New Pinery Rd, Divine Savior Healthcare Inc, Portage, WI 53901-9257 | 2005-11-22 |
| 1881208635 | Sophie M Tessner | Pharmacist | 2817 New Pinery Rd, Portage, WI 53901-9240 | 2020-08-31 |
| 1164047015 | Stephanie Jo Holt | Nurse Practitioner | 2817 New Pinery Rd, Portage, WI 53901-9240 | 2020-06-16 |
| 1770132268 | Anna Carole Hormig | Registered Nurse | 2817 New Pinery Rd, Portage, WI 53901-9240 | 2019-09-06 |
| 1790338655 | Andrea Olsen | Occupational Therapist | 2817 New Pinery Rd, Portage, WI 53901-9240 | 2019-07-19 |
| 1316590417 | Nicole Rae Sletten | Occupational Therapy Assistant | 2817 New Pinery Rd, Portage, WI 53901-9240 | 2019-07-18 |
| 1851944078 | Andrew Larson | Physical Therapist | 2817 New Pinery Rd, Portage, WI 53901-9240 | 2019-07-17 |
| 1780236067 | Danielle Debruyne | Physical Therapist | 2817 New Pinery Rd, Portage, WI 53901-9240 | 2019-07-16 |
| 1063077055 | Dillon Via | Physician Assistant | 2817 New Pinery Rd, Portage, WI 53901-9240 | 2019-05-06 |
| 1659843886 | Andrew Benton Padley | Registered Nurse | 2817 New Pinery Rd, Portage, WI 53901-9240 | 2018-12-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740710748 | Robert James Corliss | Internal Medicine | St. Vincent Fmc, 140east Cook St., Portage, WI 53901 | 2017-06-13 |
| 1639328867 | Casey Jo Ambort | Speech-Language Pathologist | 626 East Slifer St, Portage, WI 53901 | 2008-09-11 |
| 1871767400 | Planned Parenthood of Wi, Inc | Non-Pharmacy Dispensing Site | 132 W. Cook St., Portage, WI 53901 | 2008-04-15 |
| 1881872158 | Marta Jean Jindra | Physical Therapist | 626 E Slifer Street, Portage, WI 53901 | 2008-02-08 |
| 1699953976 | Lana Marie Edwards | Speech-Language Pathologist | 626 East Slifer Street, Portage, WI 53901 | 2008-02-08 |
| 1134314552 | Kristina Hellenbrand | Physical Therapist | 2639 New Pinery Road, Suite 2, Portage, WI 53901 | 2007-09-10 |
| 1689727810 | Gregory Allan Bindl | Chiropractor | 2121new Pinery Rd, Portage, WI 53901 | 2007-01-19 |
| 1720149156 | Timothy J Rosin Dds Sc | Dentist | 2570 New Pinery Rd, Portage, WI 53901 | 2006-12-12 |
| 1710083779 | Currani Seubert Dental Office LLC | Dentist | 260 W Cook St, Portage, WI 53901 | 2006-09-16 |
| 1225090525 | University of Wisconsin Medical Foundation Inc | Durable Medical Equipment & Medical Supplies | 2977 Cty Hwy Cx, Portage, WI 53901 | 2006-04-04 |
| Find all providers in zip 53901 | ||||
| Taxonomy Code | 207QS0010X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Specialization | Sports Medicine |
| A family medicine physician that is trained to be responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention of injury and illness. A sports medicine physician must have knowledge and experience in the promotion of wellness and the prevention of injury. Knowledge about special areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation, injuries (treatment and prevention and referral practice) and the role of exercise in promoting a healthy lifestyle are essential to the practice of sports medicine. The sports medicine physician requires special education to provide the knowledge to improve the health care of the individual engaged in physical exercise (sports) whether as an individual or in team participation. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Family Medicine, 2007. http://www.theabfm.org/. American Osteopathic Board of Family Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811203706 | Matthew M Brown | Family Medicine | 1705 Hoffman St, Madison, WI 53704-2510 | 2010-08-30 |
| 1174764906 | Mark W Niedfeldt, Md, LLC | Family Medicine | 10556 N Port Washington Rd, Ste 101, Mequon, WI 53092-5586 | 2009-03-06 |
| 1225151558 | Patrick Earl Mcdonough | Family Medicine | 235 State Street, St. Croix Falls, WI 54024 | 2007-04-10 |
| 1790858462 | Shanyn Colleen Lancaster | Family Medicine | 1250 W Wisconsin Ave, Student Health, Schroeder Complex, Lower Level, Milwaukee, WI 53233-2225 | 2006-11-17 |
| 1306919907 | Steven Alan Giles | Family Medicine | 3316 Ridgeline Dr, Waukesha, WI 53188 | 2006-11-15 |
| 1689220527 | Delo Sport and Stem Sc | Family Medicine | 2595 Development Dr Ste 140, Green Bay, WI 54311-4267 | 2019-08-15 |
| 1417377755 | Todd Domeyer | Family Medicine | 3113 Saemann Ave, Sheboygan, WI 53081 | 2014-04-25 |
| 1972949501 | Chad Joseph Giles | Family Medicine | 4100 State Highway 66, Stevens Point, WI 54482 | 2013-05-22 |
| 1073956363 | Lucianne Helena Olewinski | Family Medicine | Uw Hospital and Clinics, 600 Highland Ave, Madison, WI 53792-0001 | 2013-04-17 |
| 1902166978 | Jessica L Juntunen | Family Medicine | 5200 Hummingbird Rd, Suite 100, Wausau, WI 54401-6312 | 2012-05-23 |
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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.