GERALD JOHN BANNASCH (NPI# 1528091030) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528091030 |
| Entity Type | Individual |
| Full Name | GERALD JOHN BANNASCH |
| Credential | MD |
| Practice Address |
1611 S Madison St Appleton WI 54915-1844 |
| Practice Telephone | 9207305470 |
| Mailing Telephone | 9207305470 |
| Enumeration Date | 2006-07-08 |
| Last Update Date | 2015-09-14 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
01036452A | IN | Allopathic & Osteopathic Physicians |
| Y | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
43244 | WI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 34094500 | 05 | |
| OH | 0140539 | 05 | |
| IN | 100248250 | 05 | |
| IN | ANTHEM (REID PHYSICIAN ASSOCIATES, INC.) | 000000946790 | 01 |
| Street Address |
1611 S MADISON ST |
| City | APPLETON |
| State | WI |
| Zip Code | 54915-1844 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326032228 | Dirk T Fisher | Urology | 1611 S Madison St, Appleton, WI 54915-1844 | 2005-09-07 |
| 1417232752 | Alexa Liane Juzenas | Physician Assistant | 1611 S Madison St, Appleton, WI 54915 | 2011-10-19 |
| 1962700286 | Sara M. Calmes | Nurse Practitioner | 1611 S Madison St, Appleton, WI 54915-1844 | 2011-03-10 |
| 1720239635 | Cheryl A Vienola | Specialist/Technologist, Other | 1611 S Madison St, Appleton, WI 54915-1844 | 2008-10-09 |
| 1730346214 | Ascension Medical Group-fox Valley Wisconsin, Inc | Clinic/Center | 1611 S Madison St, Appleton, WI 54915 | 2008-05-21 |
| 1740457217 | Comprehensive Cardiovascular Care, LLP | Internal Medicine | 1611 S Madison St, Appleton, WI 54915-1844 | 2008-05-13 |
| 1912003377 | Ascension Medical Group-fox Valley Wisconsin, Inc | Durable Medical Equipment & Medical Supplies | 1611 S Madison St, Appleton, WI 54915 | 2006-09-15 |
| 1902848377 | Anthony Paul Zeimet | Internal Medicine | 1611 S Madison St, Appleton, WI 54915-1844 | 2006-06-12 |
| 1932163524 | Ronald W Slovick | Urology | 1611 S Madison St, Appleton, WI 54915-1844 | 2006-04-12 |
| 1790757243 | Jean E Dill | Nurse Practitioner | 1611 S Madison St, Appleton, WI 54915-1844 | 2006-02-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205466737 | Leyes Robers Dental LLC | Dentist | 3216 W County Rd Kk, Appleton, WI 54915 | 2020-01-23 |
| 1912426958 | Shanna L. Larsen | Registered Nurse | 1101 E. South River St., Appleton, WI 54915 | 2017-09-11 |
| 1477082816 | Amy Fazel | Driver | 226 E Calumet St, Appleton, WI 54915 | 2017-06-08 |
| 1871940213 | B.a.israel LLC | Community Based Residential Treatment Facility, Mental Illness | N9520 Silver Court, Appleton, WI 54915 | 2016-05-16 |
| 1982933479 | Stephanie I. Braski | Counselor | 1531 S. Oneida St, Appleton, WI 54915 | 2009-12-14 |
| 1386808319 | Shawn S Williamson | Emergency Medicine | 1506 South Oneida Street, Appleton, WI 54915 | 2008-07-18 |
| 1700040870 | Heidi Jo Van Toll | Occupational Therapist | 1335 S Oneida Street, Appleton, WI 54915 | 2008-07-17 |
| 1669639142 | Ascension Medical Group-fox Valley Wisconsin, Inc | Clinic/Center | N9642 County Rd N, Appleton, WI 54915 | 2008-05-21 |
| 1265699748 | Ascension Medical Group-fox Valley Wisconsin, Inc | Clinic/Center | 1531 S Madison St Fl 4, Appleton, WI 54915 | 2008-05-21 |
| 1073770558 | Ascension Medical Group-fox Valley Wisconsin, Inc | Clinic/Center | 1531 S Madison St Ste 580, Appleton, WI 54915 | 2008-05-21 |
| Find all providers in zip 54915 | ||||
| Taxonomy Code | 2084N0400X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Neurology |
| A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235647793 | Midwest Monitoring, LLC | Psychiatry & Neurology | 4321 W College Ave Ste 200, Appleton, WI 54914 | 2018-01-18 |
| 1528077583 | Dominic Theodore Cardelli | Psychiatry & Neurology | 2500 E Enterprise Ave Ste E, Appleton, WI 54913-8557 | 2006-08-07 |
| 1851607170 | Neurology Associates LLC | Psychiatry & Neurology | 2500 E Enterprise Ave, Suite E, Appleton, WI 54913-8557 | 2010-08-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689162661 | Tseun Han James Kong | Psychiatry & Neurology | Uw Hospitals and Clinics, 600 Highland Ave, Madison, WI 53792 | 2018-04-25 |
| 1235630625 | The Cervical Spine Institute and Neuromonitoring, LLC | Psychiatry & Neurology | 2221 S Webster Ave # 268, Green Bay, WI 54301-2158 | 2018-02-22 |
| 1477937274 | Baycare Clinic LLP | Psychiatry & Neurology | 4801 Expo Drive, Manitowoc, WI 54220 | 2015-07-13 |
| 1184011975 | Abdulrahim Ismail | Psychiatry & Neurology | 3003 University Dr Ste 203, Marinette, WI 54143-4110 | 2015-04-20 |
| 1033505821 | Heydi Flores Podadera | Psychiatry & Neurology | 721 N Midvale Blvd, Madison, WI 53705-3233 | 2015-04-08 |
| 1104221092 | Sharon Anne Bremer | Psychiatry & Neurology | 423 Landimore Ln, Wales, WI 53183-9552 | 2014-11-04 |
| 1891120093 | Robert T Schmidt Jr. | Psychiatry & Neurology | 2460 Old Plank Rd, De Pere, WI 54115-8658 | 2013-09-06 |
| 1356656771 | Klasinski Neurocare, Sc | Psychiatry & Neurology | 500 Vincent St Ste B, Stevens Point, WI 54481-1842 | 2010-08-10 |
| 1497931661 | Audrey Jantzen | Psychiatry & Neurology | 1685 Highland Ave, Department of Neurology - Centennial Building, Madison, WI 53705-2281 | 2008-01-17 |
| 1295919173 | Denis Nathan | Psychiatry & Neurology | 2589 N Terrace Ave, Milwaukee, WI 53211-3821 | 2007-12-27 |
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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.