DR. IAN R POWELL (NPI# 1346212545) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346212545 |
| Entity Type | Individual |
| Full Name | DR. IAN R POWELL |
| Credential | M.D. |
| Practice Address |
34700 Valley Rd Oconomowoc WI 53066-4500 |
| Practice Telephone | 2626461391 |
| Practice Fax Number | 2626461393 |
| Enumeration Date | 2006-02-02 |
| Last Update Date | 2012-10-20 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103TA0400X |
Psychologist Specialization: Addiction (Substance Use Disorder) |
39133 | WI | Behavioral Health & Social Service Providers |
| N | 207R00000X | Internal Medicine | 39133 | WI | Allopathic & Osteopathic Physicians |
| Y | 207RA0401X |
Internal Medicine Specialization: Addiction Medicine |
39133 | WI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 32580600 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124231535 | Ian Powell | Speech-Language Pathologist | 12555 Sw 3rd St, Beaverton, OR 97005-0517 | 2007-05-08 |
| 1326267048 | Ian David Powell | General Practice | 4800 Olde Towne Parkway Suite 320, Marietta, GA 30068-2304 | 2007-04-24 |
| 1124642459 | Ian Q Powell | Behavior Technician | 2940 N Church St Ste 303, Layton, UT 84040-6617 | 2020-06-02 |
| Street Address |
34700 VALLEY RD |
| City | OCONOMOWOC |
| State | WI |
| Zip Code | 53066-4500 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518959436 | Bradley Christopher Riemann | Psychologist | 34700 Valley Rd, Oconomowoc, WI 53066-4500 | 2005-08-17 |
| 1508477142 | Kiah Allen | Nurse Practitioner | 34700 Valley Rd, Oconomowoc, WI 53066-4500 | 2020-08-16 |
| 1477183069 | Beth Marie Calvert | Nurse Practitioner | 34700 Valley Rd, Oconomowoc, WI 53066-4500 | 2020-01-22 |
| 1609410364 | Lateisha Prescott | Registered Nurse | 34700 Valley Rd, Oconomowoc, WI 53066-4599 | 2019-11-05 |
| 1508342130 | Allison Ann Barton | Registered Nurse | 34700 Valley Rd, Oconomowoc, WI 53066-4500 | 2018-07-17 |
| 1821503640 | Nicholas R Farrell | Psychologist | 34700 Valley Rd, Oconomowoc, WI 53066-4500 | 2017-12-04 |
| 1699291757 | Laura Ann Heidelmeier | Nurse Practitioner | 34700 Valley Rd, Oconomowoc, WI 53066-4500 | 2017-08-20 |
| 1508388927 | Hilary Kay Boyd | Nurse Practitioner | 34700 Valley Rd, Oconomowoc, WI 53066-4500 | 2017-07-07 |
| 1275929051 | Nicholas Edward Mahoney | Psychiatry & Neurology | 34700 Valley Rd, Oconomowoc, WI 53066 | 2015-04-08 |
| 1013346725 | Jodi Tompitch | Nurse Practitioner | 34700 Valley Rd, Oconomowoc, WI 53066-4500 | 2013-11-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376109082 | Sharon Legwinski | Occupational Therapist | 2195 N. Summit Way, Oconomowoc, WI 53066 | 2019-05-17 |
| 1033676390 | Paladina Health, LLC | Family Medicine | Paladina Health Oconomowoc Sentry Equipment Circle, 966 Blue Ribbon Circle N, Oconomowoc, WI 53066 | 2019-02-22 |
| 1689145500 | Oconomowoc Developmental Training Center of Wisconsin LLC | Residential Treatment Facility, Emotionally Disturbed Children | 36100 Genesee Lake School, Oconomowoc, WI 53066 | 2018-12-17 |
| 1649748203 | Ginny Dacquisto | Dietitian, Registered | 1134 Lily Rd, Oconomowoc, WI 53066 | 2018-11-12 |
| 1174000764 | Aimee M Metzger | Social Worker | 405 E Forest St Ste 113, Oconomowoc, WI 53066 | 2018-07-26 |
| 1023482569 | Forefront Dermatology, S.c. | Dermatology | 1320 Pabst Farms Cir, Suite 180, Oconomowoc, WI 53066 | 2015-11-20 |
| 1962890475 | Monica Rodriguez | Counselor | 405 East Forest Street, Suite 119, Oconomowoc, WI 53066 | 2015-01-06 |
| 1518384643 | Kimberley Bevan | Pharmacist | 1284 East Summit Avenue, Suite 100, Oconomowoc, WI 53066 | 2014-03-26 |
| 1699098905 | Heidi Eckroth Nunnemacher | Counselor | 35315 Genesee Lake Road, Oconomowoc, WI 53066 | 2010-03-02 |
| 1669705240 | Oconomowoc Development Training Center Ll | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 3222 N. Silver Cedar Rd., Oconomowoc, WI 53066 | 2009-09-14 |
| Find all providers in zip 53066 | ||||
| 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 |
| 1285824029 | Larry L Heller | Internal Medicine | 430 E Division St, Fond Du Lac, WI 54935-4560 | 2007-07-27 |
| Find all providers with the same taxonomy | ||||
| City | OCONOMOWOC |
| Zip Code | 53066 |
Please comment or provide details below to improve the information on DR. IAN R POWELL.
| 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.