KERRY S DERNBACH (NPI# 1306944152) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306944152 |
| Entity Type | Individual |
| Full Name | KERRY S DERNBACH |
| Credential | DPM |
| Practice Address |
3501 Cranberry Blvd Weston WI 54476 |
| Mailing Address |
1000 N Oak Ave Marshfield WI 54449-5777 |
| Practice Telephone | 7153931000 |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213E00000X | Podiatrist | 900 | WI | Podiatric Medicine & Surgery Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 43239100 | 05 |
| Street Address |
3501 CRANBERRY BLVD |
| City | WESTON |
| State | WI |
| Zip Code | 54476 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972500718 | William J Moran | Otolaryngology | 3501 Cranberry Blvd, Weston, WI 54476-5213 | 2005-07-07 |
| 1356956015 | Stacey Lee Meyer | Nurse Practitioner | 3501 Cranberry Blvd, Weston, WI 54476-5213 | 2020-09-10 |
| 1992336655 | Mchs Hospitals, Inc. | Clinic/Center | 3501 Cranberry Blvd, Weston, WI 54476-5213 | 2020-01-31 |
| 1548804511 | Alyssa Anne Hovda | Dietitian, Registered | 3501 Cranberry Blvd, Weston, WI 54476-5213 | 2019-11-03 |
| 1144875824 | Rebecca Ann Kollross | Physician Assistant | 3501 Cranberry Blvd, Weston, WI 54476 | 2019-08-08 |
| 1891266060 | Laura Lauer | Nurse Practitioner | 3501 Cranberry Blvd, Weston, WI 54476-5213 | 2018-12-16 |
| 1356816201 | Khamal Misra | Nurse Practitioner | 3501 Cranberry Blvd, Weston, WI 54476-5213 | 2018-10-08 |
| 1164915971 | Crystal Farrand | Physician Assistant | 3501 Cranberry Blvd, Weston, WI 54476-5213 | 2018-06-07 |
| 1336663863 | Elijah Blair | Physician Assistant | 3501 Cranberry Blvd, Weston, WI 54476-5213 | 2017-07-26 |
| 1275915597 | Kari Mizgalski | Dietitian, Registered | 3501 Cranberry Blvd, Weston, WI 54476-5213 | 2015-06-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407406309 | Kelly Hodge | Technician | 118 Marguerite St, Schofield, WI 54476 | 2019-09-13 |
| 1427557529 | Brandon David Parmer | Licensed Practical Nurse | 134 Kurth St, Schofield, WI 54476 | 2018-02-05 |
| 1558880583 | Kellie Cares Medical, LLC | Non-emergency Medical Transport (VAN) | 4311 Schofield Ave, #97, Weston, WI 54476 | 2017-09-11 |
| 1679018022 | Alexis Legenza | Behavioral Analyst | 4601 Camp Phillips Rd, Weston, WI 54476 | 2016-12-21 |
| 1699176487 | Reenu Mathew | Pharmacist | 5305 U.S. Hwy Business 51, Weston, WI 54476 | 2014-09-11 |
| 1063812246 | Brian Weiland | Psychologist | 2405 Schofield Ave Ste 220, Weston, WI 54476 | 2014-08-25 |
| 1194087759 | Susan C Coady | Physical Therapist | 4605 Valres Springs Court, Weston, WI 54476 | 2012-06-11 |
| 1053437467 | Emmie Jo Kasat | Speech-Language Pathologist | 4605 Valdres Springs Court, Weston, WI 54476 | 2007-03-21 |
| 1326181322 | Lisa Marie Skutak | Dentist | 700 Eagle Nest Boulevard, Suite E, Rothschild, WI 54476 | 2007-02-15 |
| 1205976776 | Quirt Family Dentistry Sc | Dentist | 3417 Schofield Avenue, Schofield, WI 54476 | 2007-02-07 |
| Find all providers in zip 54476 | ||||
| Taxonomy Code | 213E00000X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| A podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659439321 | Family Foot and Ankle Clinic LLC | Podiatrist | 5403 Normandy St, Weston, WI 54476-2217 | 2006-12-05 |
| 1225062631 | David Allen Anderson | Podiatrist | 437 Main Ave, Weston, WV 26452-2047 | 2006-07-10 |
| 1073500526 | Joel J Tikalsky | Podiatrist | 2405 Schofield Ave Ste 110, Weston, WI 54476-6421 | 2005-09-30 |
| 1144450412 | Mark W Thomas | Podiatrist | 2405 Schofield Ave, Suite 110, Weston, WI 54476-2300 | 2009-07-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376161976 | Family Foot and Ankle Clinic LLC | Podiatrist | 1901 Westwood Boulevard, Wausau, WI 54401 | 2020-07-09 |
| 1588282453 | Family Foot and Ankle Clinic LLC | Podiatrist | 1021 Western Ave Ste C, Mosinee, WI 54455-1511 | 2020-07-08 |
| 1376161240 | Family Foot and Ankle Clinic LLC | Podiatrist | 1439 Churchill St Ste 202, Waupaca, WI 54981-2089 | 2020-07-08 |
| 1083237754 | Baycare Clinic LLP | Podiatrist | 630 Riverfront Dr, Sheboygan, WI 53081-4615 | 2020-05-28 |
| 1922637107 | Torhorst Foot and Ankle Clinic, Sc | Podiatrist | 2823 Post Rd, Stevens Point, WI 54481-6416 | 2020-04-08 |
| 1528446713 | Jonathan Shih | Podiatrist | 9200 W Loomis Rd Ste 116, Franklin, WI 53132 | 2015-05-08 |
| 1912310152 | Wyatt Isaac Wiedenfeld | Podiatrist | 853 S Main St, Oconto Falls, WI 54154-1203 | 2014-06-05 |
| 1710397039 | Kristina Lorene Thompson | Podiatrist | 37868 Us-18, Prairie Du Chien, WI 53821 | 2014-05-08 |
| 1972856169 | Midwest Foot and Wound Care Center LLC | Podiatrist | W3853 Stoneridge Dr, Fond Du Lac, WI 54937-6201 | 2012-10-25 |
| 1073880936 | Tahir A Khan | Podiatrist | 6001 W Center St Ste 108, Milwaukee, WI 53210-2154 | 2011-11-21 |
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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.