DR. TERESA ANN MALLETT (NPI# 1366949026) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366949026 |
| Entity Type | Individual |
| Full Name | DR. TERESA ANN MALLETT |
| Credential | MD |
| Practice Address |
800 West Ave S La Crosse WI 54601-8806 |
| Mailing Address |
Po Box 1510 Eau Claire WI 54702 |
| Practice Telephone | 6087850940 |
| Practice Fax Number | 6083924168 |
| Mailing Telephone | 7158385222 |
| Enumeration Date | 2018-04-10 |
| Last Update Date | 2020-09-16 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 72017 | WI | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871514539 | Teresa Lynn Mallett | Counselor | 13504 Stevens St, Suite A, Omaha, NE 68137-1634 | 2006-07-21 |
| Street Address |
800 WEST AVE S |
| City | LA CROSSE |
| State | WI |
| Zip Code | 54601-8806 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154323467 | Evan R Nelson | Physical Medicine & Rehabilitation | 800 West Ave S, La Crosse, WI 54601 | 2005-06-01 |
| 1366002479 | Caitlin Rae Carpenter | Physician Assistant | 800 West Ave S, La Crosse, WI 54601-8806 | 2019-06-20 |
| 1619448412 | Jenna Bauer | Nurse Practitioner | 800 West Ave S, La Crosse, WI 54601-8806 | 2018-12-06 |
| 1871077198 | Grant Morgan | Physician Assistant | 800 West Ave S, La Crosse, WI 54601-8806 | 2018-09-21 |
| 1477034411 | Navid Khezri | Neurological Surgery | 800 West Ave S, La Crosse, WI 54601-8806 | 2018-08-28 |
| 1609356468 | Alexander Ehlert | Physical Therapist | 800 West Ave S, La Crosse, WI 54601 | 2018-08-20 |
| 1316426091 | Jenifer Bantle-felt | Nurse Practitioner | 800 West Ave S, La Crosse, WI 54601 | 2018-08-13 |
| 1881199545 | Emily French | Family Medicine | 800 West Ave S, La Crosse, WI 54601-8806 | 2018-03-26 |
| 1073035598 | Mariah Hall | Nurse Practitioner | 800 West Ave S, La Crosse, WI 54601-8806 | 2017-07-17 |
| 1124564000 | Andrew Novak | Physician Assistant | 800 West Ave S, La Crosse, WI 54601 | 2017-01-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891324265 | Meagan Mcrae | Student in an Organized Health Care Education/Training Program | 1725 State St., 4051 Health Science Center, La Crosse, WI 54601 | 2020-04-07 |
| 1255969671 | Erin Dingman | Student in an Organized Health Care Education/Training Program | 1751 State Street, 4051 Health Science Center, La Crosse, WI 54601 | 2020-03-31 |
| 1619505047 | Nicole Kay Lynch | Student in an Organized Health Care Education/Training Program | 4051 Health Science Center, 1725 State St, La Crosse, WI 54601 | 2020-03-31 |
| 1174151757 | Jenna Sells | Student in an Organized Health Care Education/Training Program | 4051 Health Science Center, 1725 State Street, La Crosse, WI 54601 | 2020-03-30 |
| 1740818301 | Katie Irene Tahtinen | Student in an Organized Health Care Education/Training Program | Uwl- 4051 Health Science Center, 1725 State St., La Crosse, WI 54601 | 2020-03-30 |
| 1932737517 | Margaret May Grimm | Student in an Organized Health Care Education/Training Program | Univesity of Wisconsin-la Crosse, 4051 Health Science Center, 1725 State Street, La Crosse, WI 54601 | 2020-03-30 |
| 1831727312 | Matthew Timothy Axler | Student in an Organized Health Care Education/Training Program | 4051 Health Science Center, 1725 State Street, La Crosse, WI 54601 | 2020-03-30 |
| 1093340473 | Denise Stinson | Technician | 1311 Badger St, Apt 505, La Crosse, WI 54601 | 2020-03-06 |
| 1922632397 | Ibrahim Ahsan | Pharmacist | 1105 Wi-16, La Crosse, WI 54601 | 2020-02-25 |
| 1750913356 | Liza R Collins | Massage Therapist | 1415 State Wi 16, La Crosse, WI 54601 | 2020-02-11 |
| Find all providers in zip 54601 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407120702 | Stephen Kimball Stacey | Family Medicine | 815 South 10th St, La Crosse, WI 54601-4764 | 2012-03-04 |
| 1083797294 | John G Jaeger | Family Medicine | 630 10th St S, La Crosse, WI 54601 | 2006-10-23 |
| 1922042761 | Vrushali Vinayak Pidady | Family Medicine | 2600 State Rd, La Crosse, WI 54601-6157 | 2006-06-15 |
| 1194786673 | Edward J Malone IIi | Family Medicine | 815 10th Street S., La Crosse, WI 54601-4700 | 2006-04-01 |
| 1538130927 | Gregory Olson | Family Medicine | W5525 Southdale Dr, La Crosse, WI 54601-7147 | 2006-02-01 |
| 1578550281 | John M. Merfeld | Family Medicine | 815 10th St S, La Crosse, WI 54601-4764 | 2005-09-29 |
| 1417951856 | Karen K Cowan | Family Medicine | 815 S. 10th Street, La Crosse, WI 54601-4700 | 2005-06-13 |
| 1083618722 | Teddy Leonard Thompson | Family Medicine | 1526 Rose Street, La Crosse, WI 54603 | 2005-06-10 |
| 1780213256 | Michael Scott Bassett | Family Medicine | 815 10th St S, La Crosse, WI 54601-4764 | 2020-04-06 |
| 1376172213 | Elizabeth Ann Husted | Family Medicine | 815 10th St S, La Crosse, WI 54601-4764 | 2020-04-03 |
| Find all providers in LA CROSSE | ||||
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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.