CALLISIA CLARKE (NPI# 1275752578) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275752578 |
| Entity Type | Individual |
| Full Name | CALLISIA CLARKE |
| Credential | MD |
| Practice Address |
9200 W Wisconsin Ave Surgical Oncology Milwaukee WI 53226-3522 |
| Practice Telephone | 4148055020 |
| Practice Fax Number | 4148055771 |
| Mailing Telephone | 4148055020 |
| Mailing Fax Number | 4148055771 |
| Enumeration Date | 2007-04-25 |
| Last Update Date | 2016-12-12 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208600000X | Surgery | P5611 | TX | Allopathic & Osteopathic Physicians |
| N | 208600000X | Surgery | 57012026 | OH | Allopathic & Osteopathic Physicians |
| Y | 2086X0206X |
Surgery Specialization: Surgical Oncology |
66205 | WI | Allopathic & Osteopathic Physicians |
| N | 2086X0206X |
Surgery Specialization: Surgical Oncology |
P5611 | TX | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 320489301 | 05 | |
| TX | BCBS | 8DT082 | 01 |
| Street Address |
9200 W WISCONSIN AVE SURGICAL ONCOLOGY |
| City | MILWAUKEE |
| State | WI |
| Zip Code | 53226-3522 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255334173 | Froedtert Memorial Lutheran Hospital, Inc. | General Acute Care Hospital | 9200 W Wisconsin Ave, Milwaukee, WI 53226-3522 | 2005-05-24 |
| 1013518182 | Shelby Koppinger | Pharmacist | 9200 W Wisconsin Ave, Milwaukee, WI 53226-3522 | 2020-11-05 |
| 1083215065 | Jennifer Lynn Scheffler | Physician Assistant | 9200 W Wisconsin Ave, Milwaukee, WI 53226-3522 | 2020-11-05 |
| 1306445952 | Elyan Carolina Ruiz Solano | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 9200 W Wisconsin Ave, Milwaukee, WI 53226-3522 | 2020-10-23 |
| 1972101467 | Sarah Emily Ziem | Nurse Practitioner | 9200 W Wisconsin Ave, Milwaukee, WI 53226-3522 | 2020-10-15 |
| 1912504242 | Matthew Resop | Nurse Practitioner | 9200 W Wisconsin Ave, Milwaukee, WI 53226-3522 | 2020-10-09 |
| 1043817877 | Jacqueline Jordan Morgan | Nurse Practitioner | 9200 W Wisconsin Ave, Milwaukee, WI 53226-3522 | 2020-10-05 |
| 1134726227 | Joseph Beiler | Registered Nurse | 9200 W Wisconsin Ave, Milwaukee, WI 53226-3522 | 2020-10-02 |
| 1316553845 | Nathan Duncan | Pharmacist | 9200 W Wisconsin Ave, Milwaukee, WI 53226-3522 | 2020-09-21 |
| 1043826035 | Emily Mell | Physician Assistant | 9200 W Wisconsin Ave, Milwaukee, WI 53226-3522 | 2020-09-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912511155 | Alexander Harlan | Pharmacist | 900 N 92nd St, Milwaukee, WI 53226 | 2020-09-04 |
| 1558985762 | Armghan Haider Ans | Student in an Organized Health Care Education/Training Program | 9200 W. Wisconsin Ave. Froedtert Hospital & Medical Col, Milwaukee, WI 53226 | 2020-06-03 |
| 1669001103 | Kimberly Tyler | Student in an Organized Health Care Education/Training Program | 8701 W Watertown Plank Road, Medical College of Wisconsin Dept of Internal Medicine, Wauwatosa, WI 53226 | 2020-04-06 |
| 1972131993 | Francesca Meloy Devine | Student in an Organized Health Care Education/Training Program | Medical Education Office: Children's Corporate Center, 999 N. 92nd St., Suite 730, Milwaukee, WI 53226 | 2020-03-27 |
| 1285275248 | Sharitta Alford | Technician | 12250 West North Avenue, Apartment 142b, Wauwatosa, WI 53226 | 2019-10-01 |
| 1619528023 | Linda Marie Sabatinelli | Technician | 12107 W. Woodland Ave, Wauwatosa, WI 53226 | 2019-09-26 |
| 1598310195 | Matthew Laviolette | Surgery | Medical College of Wisconsin, 8701 Watertown Plank Rd., Surgical Oncology, Milwaukee, WI 53226 | 2019-08-09 |
| 1962056432 | Lyndsey Marie Bratberg | Physician Assistant | F&mcw Clinical Cancer Center 9200 W. Wisconsin Ave., Milwaukee, WI 53226 | 2019-08-01 |
| 1659832855 | Benjamin David Seadler | Surgery | Mcw, Department of Surgery, 8701 Watertown Plank Road, Milwaukee, WI 53226 | 2019-03-29 |
| 1861953267 | Michael Dryden | Student in an Organized Health Care Education/Training Program | 8701 Watertown Plank Rd., Milwaukee, WI 53226 | 2019-03-27 |
| Find all providers in zip 53226 | ||||
| Taxonomy Code | 2086X0206X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Surgical Oncology |
| A surgical oncologist is a well-qualified surgeon who has obtained additional training and experience in the multidisciplinary approach to the prevention, diagnosis, treatment, and rehabilitation of cancer patients, and devotes a major portion of his or her professional practice to these activities and cancer research. |
| Notes: Source: Society of Surgical Oncology, 2007 [1/1/2008: definition added, source added, 7/1/2009: definiition reformatted] Additional Resources: http://www.surgonc.org/ ; American Board of Medical Specialties, 2007, www.abms.org ; American Board of Surgery, 2007, http://www.absurgery.org/ Surgical oncology is a recognized fellowship subspecialty program of surgery. Separate board certification is not currently offered. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639515661 | Chandler Scott Cortina | Surgery | 9200 W Wisconsin Ave, Milwaukee, WI 53226 | 2013-05-16 |
| 1588906804 | Sophie Dream | Surgery | 9200 W Wisconsin Ave, Milwaukee, WI 53226-3522 | 2013-03-25 |
| 1437407574 | Charles Hc Pilgrim | Surgery | 9200 W Wisconsin Ave, Surgical Oncology, Milwaukee, WI 53226-3522 | 2012-08-21 |
| 1639436629 | Geoffrey Bellini | Surgery | 2801 W Kinnickinnic River Pkwy Ste 575, Milwaukee, WI 53215-5200 | 2012-04-16 |
| 1649558735 | Isaac Roland Kriley | Surgery | 2900 W Oklahoma Ave, Milwaukee, WI 53215-4330 | 2011-07-25 |
| 1295820116 | Douglas B. Evans | Surgery | 9200 W Wisconsin Avenue, Surgical Oncology, Milwaukee, WI 53226-3522 | 2006-10-04 |
| 1073565776 | Edward Quebbeman | Surgery | 9200 W Wisconsin Ave, Surgical Oncology, Milwaukee, WI 53226-3522 | 2006-05-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871049072 | Nikolaos Chatzizacharias | Surgery | 9200 West Wisconsin Avenue, Medical College of Wisonsin, Wauwatosa, WI 53226-3596 | 2016-08-28 |
| 1760740898 | Syed Nabeel Zafar | Surgery | 600 Highland Ave, Madison, WI 53792-0001 | 2012-04-26 |
| 1770863268 | Mei Li Kwong | Surgery | 1900 South Ave, La Crosse, WI 54601-5467 | 2011-08-28 |
| 1215190210 | Jennifer Grusby Steiman | Surgery | 600 Highland Ave, Madison, WI 53792-0001 | 2008-07-09 |
| 1750412615 | Daniel Erik Abbott | Surgery | 600 Highland Ave, Madison, WI 53792-5531 | 2007-03-09 |
| 1508809195 | Sanjoy Saha | Surgery | 2116 Craig Rd, Eau Claire, WI 54701 | 2006-06-13 |
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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.