DR. SHAWN MICHAEL SANICOLA (NPI# 1457356305) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457356305 |
| Entity Type | Individual |
| Full Name | DR. SHAWN MICHAEL SANICOLA |
| Credential | DPM |
| Practice Address |
2430c N Grandview Blvd # C Waukesha WI 53188-1605 |
| Mailing Address |
2835 N Grandview Blvd Ste 300 Pewaukee WI 53072-5591 |
| Practice Telephone | 2625423779 |
| Practice Fax Number | 2625424428 |
| Mailing Telephone | 2625423779 |
| Mailing Fax Number | 2625424428 |
| Enumeration Date | 2005-06-16 |
| Last Update Date | 2019-10-07 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213E00000X | Podiatrist | 883025 | WI | Podiatric Medicine & Surgery Service Providers |
| N | 213ES0000X |
Podiatrist Specialization: Sports Medicine |
883025 | WI | Podiatric Medicine & Surgery Service Providers |
| N | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
883025 | WI | Podiatric Medicine & Surgery Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | NPI GROUP | 1316994924 | 01 |
| WI | INDIVIDUAL NPI | 1457356305 | 01 |
| Street Address |
2430C N GRANDVIEW BLVD # C |
| City | WAUKESHA |
| State | WI |
| Zip Code | 53188-1605 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336787126 | Nicole Lee Berg-johnson | Nurse Practitioner | 820 Crestwood Dr., Waukesha, WI 53188 | 2019-12-12 |
| 1013475706 | Rachel Mueller | Occupational Therapist | 29667 Summit Ave, S11, Waukesha, WI 53188 | 2019-03-12 |
| 1861962649 | Emily Elizabeth Seefeld | Occupational Therapy Assistant | 29667 Summit Ave S11, Waukesha, WI 53188 | 2018-12-05 |
| 1003393307 | Ashley Susan Callahan | Dental Hygienist | 711 W. Moreland Blvd., Suite 204, Waukesha, WI 53188 | 2018-07-19 |
| 1245741321 | Melissa Weir | Case Manager/Care Coordinator | 514 Riverview Avenue, Waukesha, WI 53188 | 2017-10-17 |
| 1093233629 | Patricia Marie Sombrio | Dental Hygienist | 711 Moreland Blvd 204, Waukesha, WI 53188 | 2017-09-04 |
| 1134660244 | Bdg of Wisconsin, Inc. | Behavioral Analyst | N19w2309 Riverwood Drive, Suite 350 Pmb 314, Waukesha, WI 53188 | 2017-03-09 |
| 1255888731 | Lynne Sarah Alva | Dental Hygienist | 711 Moreland Blvd, Suite 204, Waukesha, WI 53188 | 2016-09-01 |
| 1881069730 | Michelle Koch | Occupational Therapist | 29667 Summit Ave. S11, Waukesha, WI 53188 | 2015-12-03 |
| 1952711012 | Rhonda Schroeder | Dental Hygienist | W286 N991 Shepherds Way, Waukesha, WI 53188 | 2014-04-29 |
| Find all providers in zip 53188 | ||||
| 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 |
|---|---|---|---|---|
| 1366724478 | Visiting Md Ltd | Podiatrist | 2426 N Grandview Blvd Ste D, Waukesha, WI 53188-6905 | 2011-09-14 |
| 1689770877 | David John Guhl | Podiatrist | 20700 Watertown Rd Ste 200, Waukesha, WI 53186 | 2006-09-15 |
| 1871651570 | Waukesha Foot Specialist | Podiatrist | 2120 E Moreland Blvd, Waukesha, WI 53186 | 2006-12-05 |
| 1881661445 | Tracy R. Coulter | Podiatrist | N14w23900 Stone Ridge Dr, Prohealth Care Medical Associates Inc., Waukesha, WI 53188-1135 | 2006-03-02 |
| 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 |
| Find all providers with the same taxonomy | ||||
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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.