MATHEW LEE WIBEL (NPI# 1285105064) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1285105064 |
Entity Type | Individual |
Full Name | MATHEW LEE WIBEL |
Credential | ABC C.PED |
Practice Address |
3 Saint Charles Pl Little Chute WI 54140-2256 |
Practice Telephone | 7153079071 |
Mailing Telephone | 7153079071 |
Enumeration Date | 2018-12-05 |
Last Update Date | 2018-12-05 |
Gender Code | M |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 224L00000X | Pedorthist | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | ||
Y | 224L00000X | Pedorthist | WI | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Street Address |
3 SAINT CHARLES PL |
City | LITTLE CHUTE |
State | WI |
Zip Code | 54140-2256 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1841335536 | Dann Norbert Pynenberg | Dentist | 607 Wilson Street, Little Chute, WI 54140 | 2007-02-20 |
1043207707 | Peter J Kordiyak | Physician Assistant | 200 Patriot Drive, Little Chute, WI 54140 | 2005-09-28 |
1144731498 | Paul R Garcia | Family Medicine | 200 Patriot Dr, Little Chute, WI 54140 | 2017-10-13 |
1538451307 | Jessica L Peterson | Family Medicine | 200 Patriot Drive, Little Chute, WI 54140 | 2011-05-11 |
1043478324 | Ascension Medical Group-fox Valley Wisconsin, Inc | Clinic/Center | 200 Patriot Dr, Little Chute, WI 54140 | 2008-05-23 |
1164550208 | Ebben & Pynenberg Dds Sc | Dentist | 607 Wilson St, Little Chute, WI 54140 | 2007-03-01 |
1134264922 | Michael Charles Ebben | Dentist | 607 Wilson St, Little Chute, WI 54140 | 2007-02-20 |
1245335165 | Ascension Medical Group-fox Valley Wisconsin, Inc | Durable Medical Equipment & Medical Supplies | 200 Patriot Dr, Little Chute, WI 54140 | 2006-09-14 |
1366809758 | Katie Woldt | Registered Nurse | 1502 Biscayne Dr, Little Chute, WI 54140-1006 | 2016-01-15 |
1770878233 | Isabelle Holdridge | Registered Nurse | 1030f W Elm Dr Apt 16, Little Chute, WI 54140-1099 | 2011-06-13 |
Find all providers in zip 54140 |
Taxonomy Code | 224L00000X |
Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Classification | Pedorthist |
An individual who is trained in the management and treatment of conditions of the foot, ankle, and lower extremities requiring fitting, fabricating, and adjusting of pedorthic devices. |
Notes: Source: National Uniform Claim Committee [7/1/2010: new] Additional Resources: American Board for Certification in Orthotics, Prosthetics and Pedorthics, Inc., www.abcop.org and Board of Certification/Accreditation, International, www.bocusa.org. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1417492679 | Robert Mc Roberts Jr. | Pedorthist | 1706 York St Ste 3, Bloomer, WI 54724-1921 | 2016-12-27 |
1427616242 | Tasha Marie Gleason | Pedorthist | 902 E 1st St, Merrill, WI 54452-2508 | 2019-06-05 |
1932640414 | Kathy Karrels | Pedorthist | 2475 N 124th St, Brookfield, WI 53005-4630 | 2017-03-16 |
1366983843 | Dennis Janisse | Pedorthist | 2475 N 124th St, Brookfield, WI 53005-4630 | 2017-03-16 |
1447705033 | James Blackmer | Pedorthist | 600 Highland Ave, Madison, WI 53792-0001 | 2016-08-24 |
1124338462 | Genevieve Pressman | Pedorthist | 200 S Executive Dr, Suite 101, Brookfield, WI 53005-4216 | 2010-10-20 |
City | LITTLE CHUTE |
Zip Code | 54140 |
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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.