DR. LARRY L HELLER (NPI# 1285824029) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285824029 |
| Entity Type | Individual |
| Full Name | DR. LARRY L HELLER |
| Credential | M.D. |
| Practice Address |
430 E Division St Fond Du Lac WI 54935-4560 |
| Mailing Address |
420 E Division St Fond Du Lac WI 54935-4560 |
| Practice Telephone | 9209264200 |
| Mailing Telephone | 9209268343 |
| Enumeration Date | 2007-07-27 |
| Last Update Date | 2020-10-20 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RA0401X |
Internal Medicine Specialization: Addiction Medicine |
18156 | WI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 31081100 | 05 | |
| DEA | BH 0423145 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356432421 | Larry Joseph Heller | Pathology | 1212 Pleasant, #ll3, Des Moines, IA 50309-1414 | 2006-09-27 |
| Street Address |
430 E DIVISION ST |
| City | FOND DU LAC |
| State | WI |
| Zip Code | 54935-4560 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437157831 | Gilberto Cantu | Nurse Anesthetist, Certified Registered | 430 E Division St, Fond Du Lac, WI 54935-4560 | 2005-07-09 |
| 1992306310 | Leah Timm | Nurse Practitioner | 430 E Division St, Fond Du Lac, WI 54935-4560 | 2020-11-03 |
| 1982212312 | Tiffany M Parker | Counselor | 430 E Division St, Fond Du Lac, WI 54935-4560 | 2020-07-22 |
| 1619594355 | Brynn Sytsma | Student in an Organized Health Care Education/Training Program | 430 E Division St, Fond Du Lac, WI 54935-4560 | 2020-06-29 |
| 1891312633 | Joshua Mckinney | Counselor | 430 E Division St, Fond Du Lac, WI 54935-4560 | 2020-06-27 |
| 1275153264 | Jacalyn Lucille Wendt Coleman | Dietitian, Registered | 430 E Division St, Fond Du Lac, WI 54935-4560 | 2020-04-20 |
| 1568090884 | Jaclyn R Monteverde | Physician Assistant | 430 E Division St, Fond Du Lac, WI 54935-4560 | 2020-03-31 |
| 1235766718 | Emily Jean Thiel | Dietitian, Registered | 430 E Division St, Fond Du Lac, WI 54935-4560 | 2020-03-25 |
| 1326674136 | Alexandria Lynn Hefter | Nurse Practitioner | 430 E Division St, Fond Du Lac, WI 54935-4560 | 2020-03-13 |
| 1952933046 | Gina Paveglio | Registered Nurse | 430 E Division St, Surgery Dept, Fond Du Lac, WI 54935 | 2020-02-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609482249 | Keziah Sherri Love | Counselor | W390 Wi-23, Fond Du Lac, WI 54935 | 2020-09-18 |
| 1891341988 | Cynthia Louise Singleton | Nurse Practitioner | 16 E 13th St., Fond Du Lac, WI 54935 | 2019-08-14 |
| 1083183297 | Elena Alexandra Giese | Nurse Practitioner | 430 E. Division St, Fond Du Lac, WI 54935 | 2018-11-16 |
| 1669963740 | Elizabeth Anne Machi | Student in an Organized Health Care Education/Training Program | 885 Western Ave Ste 300, Fond Du Lac, WI 54935 | 2018-05-23 |
| 1184150021 | Jordan Moehn | Specialist/Technologist | 633 Prairie Pkwy, Fond Du Lac, WI 54935 | 2017-05-11 |
| 1467856336 | Chuentao Ho | Specialist/Technologist | 45 South National Ave., Fond Du Lac, WI 54935 | 2014-10-21 |
| 1437587961 | Paula Seeley | Nurse Practitioner | 63 West Pioneer Rd, Fond Du Lac, WI 54935 | 2013-10-18 |
| 1144516030 | Bonnie Kay Mallon | Registered Nurse | 118 E 9th St, Fond Du Lac, WI 54935 | 2011-06-20 |
| 1770885600 | Holly Shepard | Counselor | 23 W Scott St., Fond Du Lac, WI 54935 | 2010-11-29 |
| 1437479110 | Ruth Marie Bohn | Occupational Therapy Assistant | 244 North Macy Street, Fond Du Lac, WI 54935 | 2010-06-04 |
| Find all providers in zip 54935 | ||||
| Taxonomy Code | 207RA0401X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Addiction Medicine |
| An internist doctor of osteopathy that specializes in the treatment of addiction disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine can obtain a Certificate of Added Qualifications in the field of Addiction Medicine. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2007. [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952955270 | New Day Medical LLC | Internal Medicine | 4655 N Pt Wash Rd, Glendale, WI 53212-1004 | 2019-07-25 |
| 1518404854 | Cleanslate Medical Group of Wisconsin, Sc | Internal Medicine | 377 W River Woods Pkwy Ste 201, Glendale, WI 53212-1088 | 2017-01-25 |
| 1164596615 | Selahattin S. Kurter | Internal Medicine | 1661 N Water St, Suite 301, Milwaukee, WI 53202-2085 | 2006-11-17 |
| 1922627595 | Monarch Health | Internal Medicine | 521 E Washington Ave, Madison, WI 53703-2900 | 2020-04-13 |
| 1821624925 | Brittany Kay Gerovac | Internal Medicine | 521 E Washington Ave, Madison, WI 53703-2900 | 2020-03-20 |
| 1932695871 | Iris Health Clinic LLC | Internal Medicine | 403 N Grand Ave, Waukesha, WI 53186-4913 | 2018-07-03 |
| 1962911602 | Mareum Lucinda Connett | Internal Medicine | 3440 Oakwood Hills Pkwy, Eau Claire, WI 54701-7698 | 2017-09-26 |
| 1205263159 | Sullivan Medical Clinic, LLC | Internal Medicine | 6040 W Lisbon Ave, Suite 200, Milwaukee, WI 53210-2116 | 2013-10-07 |
| 1174890792 | Milind Mehta | Internal Medicine | 1220 Dewey Ave, Wauwatosa, WI 53213-2504 | 2011-11-28 |
| 1851505416 | Michael S Goldstone | Internal Medicine | 2422 North Grandview Blvd, Waukesha, WI 53188 | 2007-05-10 |
| Find all providers with the same taxonomy | ||||
| City | FOND DU LAC |
| Zip Code | 54935 |
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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.