BENJAMIN C GILLEN (NPI# 1316108343) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316108343 |
| Entity Type | Individual |
| Full Name | BENJAMIN C GILLEN |
| Credential | MD |
| Practice Address |
2845 Greenbrier Rd Green Bay WI 54311-6519 |
| Mailing Address |
164 N Broadway Green Bay WI 54303-2728 |
| Practice Telephone | 9209650007 |
| Practice Fax Number | 9202884956 |
| Mailing Telephone | 9209650007 |
| Mailing Fax Number | 9202884956 |
| Enumeration Date | 2008-06-23 |
| Last Update Date | 2016-03-23 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
63398 | WI | Allopathic & Osteopathic Physicians |
| N | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
51114 | MN | Allopathic & Osteopathic Physicians |
| Y | 2085R0204X |
Radiology Specialization: Vascular & Interventional Radiology |
63398 | WI | Allopathic & Osteopathic Physicians |
| N | 2085R0204X |
Radiology Specialization: Vascular & Interventional Radiology |
01072278A | IN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | ENROLLED | 05 | |
| IA | ENROLLED | 05 |
| Street Address |
2845 GREENBRIER RD |
| City | GREEN BAY |
| State | WI |
| Zip Code | 54311-6519 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265435853 | Cynthia L Geocaris | Surgery | 2845 Greenbrier Rd, Green Bay, WI 54311-6519 | 2005-05-27 |
| 1659978872 | Molly Linzmeier | Registered Nurse | 2845 Greenbrier Rd, Green Bay, WI 54311-6519 | 2020-10-01 |
| 1588279756 | Toni M Pullen | Massage Therapist | 2845 Greenbrier Rd, Green Bay, WI 54311-6519 | 2020-09-14 |
| 1700413283 | Michelle Yvonne Degrave | Registered Nurse | 2845 Greenbrier Rd, Green Bay, WI 54311-6519 | 2020-03-25 |
| 1588299697 | Amanda Marie Steinfeldt | Nurse Practitioner | 2845 Greenbrier Rd, Green Bay, WI 54311-6519 | 2020-03-09 |
| 1659906113 | Kelly Jane Delzer | Nurse Practitioner | 2845 Greenbrier Rd, Green Bay, WI 54311-6519 | 2020-03-05 |
| 1750915815 | Jennifer Maronek | Occupational Therapist | 2845 Greenbrier Rd, Green Bay, WI 54311-6519 | 2020-02-27 |
| 1538792379 | Sierra R Milosch | Occupational Therapist | 2845 Greenbrier Rd, Green Bay, WI 54311-6519 | 2020-02-20 |
| 1205473584 | Mackenzie L Zuleger | Nurse Practitioner | 2845 Greenbrier Rd, Green Bay, WI 54311-6519 | 2019-12-05 |
| 1588214860 | Jessica S Thompson | Nurse Practitioner | 2845 Greenbrier Rd, Green Bay, WI 54311-6519 | 2019-09-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295333847 | Karen Ginnow | Pharmacist | Walmart #1908, 2292 Main St, Green Bay, WI 54311 | 2020-10-15 |
| 1639786551 | Maggie Hall | Dental Hygienist | 2633 Development Dr. Ste 40, Green Bay, WI 54311 | 2020-09-24 |
| 1295370807 | Jennifer Marie Arendt | Technician | 2970 Mossy Oak Cir #39, Green Bay, WI 54311 | 2019-11-07 |
| 1518508803 | Cheryl Ann Johnson | Specialist | 830 Edgewood Dr., Green Bay, WI 54311 | 2019-10-08 |
| 1124670898 | Robert H Wagner Family Dentist S.c. | Dentist | 2830 Curry Court, Suite 1, Green Bay, WI 54311 | 2019-07-12 |
| 1821659624 | The Salvation Army | Counselor | The Salvation Army Ray & Joan Kroc Center, 1315 Lime Kiln Road, Green Bay, WI 54311 | 2019-06-24 |
| 1578052866 | Matthew Robert Wagner | Dentist | 2830 Curry Ln #1, Green Bay, WI 54311 | 2018-05-02 |
| 1861916769 | Atlas Spinal Care | Chiropractor | 2069 Central Ct, Suite 11, Green Bay, WI 54311 | 2017-08-01 |
| 1851844161 | Green Bay Family Dental LLC | Dentist | 2609 Development Dr., Green Bay, WI 54311 | 2016-08-03 |
| 1710382809 | Betsy Hoida | Pharmacist | 2485 Greenbrier Rd., Green Bay, WI 54311 | 2014-10-31 |
| Find all providers in zip 54311 | ||||
| Taxonomy Code | 2085R0204X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Vascular & Interventional Radiology |
| A radiologist who diagnoses and treats diseases by various radiologic imaging modalities. These include fluoroscopy, digital radiography, computed tomography, sonography and magnetic resonance imaging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447327986 | Green Bay Radiology Sc | Radiology | 2941 S Ridge Rd, Green Bay, WI 54304-5517 | 2006-11-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245520840 | Sujan Swearingen | Radiology | 5931 Pilgrim Way, Racine, WI 53406-2739 | 2011-04-15 |
| 1124289657 | Farzad Rezai | Radiology | 624 N 59th St, Milwaukee, WI 53213-4214 | 2008-06-18 |
| 1679507883 | Center for Medical Imaging Inc | Radiology | W178n9912 Rivercrest Dr, Suite 102, Germantown, WI 53022-4645 | 2006-07-11 |
| 1003869140 | Interventional Procedures Group Ltd | Radiology | 2445 North Mayfair Road, Wauwatosa, WI 53226 | 2006-05-18 |
| 1063473692 | William G Wagner | Radiology | 1601 N Taylor Dr, Sheboygan, WI 53081-1930 | 2006-03-31 |
| 1902260433 | Jiahao Hu | Radiology | 2900 W Oklahoma Ave, Milwaukee, WI 53215-4330 | 2016-04-11 |
| 1720443922 | Elliott Russell | Radiology | Uw Hospitals & Clinics 600 Highland Ave, Madison, WI 53792-0001 | 2015-12-15 |
| 1104212091 | Osmani Deochand | Radiology | 9200 W Wisconsin Ave, Milwaukee, WI 53226-3522 | 2015-04-08 |
| 1447666219 | Chadi Diab | Radiology | 600 Highland Ave, Madison, WI 53792-2709 | 2014-07-01 |
| 1255743860 | Naif Hamad Alsaikhan | Radiology | 8701 W Watertown Plank Rd, Milwaukee, WI 53226-3548 | 2014-05-30 |
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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.