PAI PARTICIPANT 23 SC (NPI# 1528674801) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528674801 |
| Entity Type | Organization |
| Organization Name | PAI PARTICIPANT 23 SC |
| Practice Address |
1475 Birch Hill Ln Shawano WI 54166-3707 |
| Mailing Address |
Po Box 639676 Cincinnati OH 45263-9676 |
| Practice Telephone | 7155263161 |
| Mailing Telephone | 8592914800 |
| Mailing Fax Number | 8596558588 |
| Enumeration Date | 2020-09-22 |
| Last Update Date | 2020-09-22 |
| Authorized Official Name | ERIN LAIRD (AUTHORIZED OFFICIAL) |
| Authorized Official Telephone | 4104588713 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RG0300X |
Internal Medicine Specialization: Geriatric Medicine |
Allopathic & Osteopathic Physicians |
| Street Address |
1475 BIRCH HILL LN |
| City | SHAWANO |
| State | WI |
| Zip Code | 54166-3707 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790785475 | Birch Hill Care Center LLC | Skilled Nursing Facility | 1475 Birch Hill Ln, Shawano, WI 54166-3707 | 2005-07-26 |
| 1528665387 | Kaitlyn Rose Kreuser | Speech-Language Pathologist | 1475 Birch Hill Ln, Shawano, WI 54166-3707 | 2020-10-05 |
| 1275176125 | Nsh Shawano-birch LLC | Skilled Nursing Facility | 1475 Birch Hill Ln, Shawano, WI 54166-3707 | 2019-10-23 |
| 1285055541 | Julie Moesch | Physical Therapy Assistant | 1475 Birch Hill Ln, Shawano, WI 54166-3707 | 2014-01-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134641848 | Nicole Jeannine Klotzbuecher | Optometrist | 150 County Road B, Shawano, WI 54166 | 2017-07-13 |
| 1437605714 | Jennifer Marie Franke | Counselor | 504 Lakeland St, Shawano, WI 54166 | 2016-08-28 |
| 1699017913 | Benjamin D Schlais | Family Medicine | 100 County Hwy B, Shawano, WI 54166 | 2013-03-25 |
| 1154574366 | Luke T Johnson | Speech-Language Pathologist | N3684 River Road, Shawano, WI 54166 | 2008-10-31 |
| 1902054315 | Robert Joseph Bohr Jr. | Physical Therapy Assistant | N6590 Fox Lane, Shawano, WI 54166 | 2008-08-28 |
| 1790945863 | Patricia Rae Ainsworth | Physical Therapist | 1436 South Lincoln Street, Shawano, WI 54166 | 2008-06-12 |
| 1649491820 | Shawano-gresham School District | Local Education Agency (LEA) | 1050 South Union Street, Shawano, WI 54166 | 2007-05-02 |
| 1114043387 | Thomas G Peterson | Optometrist | 150a County Road B, Shawano, WI 54166 | 2007-03-21 |
| 1740343086 | John Milton Dovorany | Dentist | 1488 E Green Bay St, Shawano, WI 54166 | 2006-12-18 |
| 1265526305 | Charles E Lamarche | Counselor | 420 E Green Bay St, Ste 201, Shawano, WI 54166 | 2006-10-03 |
| Find all providers in zip 54166 | ||||
| Taxonomy Code | 207RG0300X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Geriatric Medicine |
| An internist who has special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes and the hospital. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487015301 | Louis Harvey Frase | Internal Medicine | 2516 E Princeton Ave, Eau Claire, WI 54703-4133 | 2016-03-20 |
| 1588045702 | Maureen Bruns | Internal Medicine | 3054 Maple Grove Dr, Madison, WI 53719-1912 | 2015-06-12 |
| 1952554966 | William Jerold Hisgen | Internal Medicine | 1215 Garfield St, 1215 Garfield St., Madison, WI 53711-2215 | 2008-11-04 |
| 1114005642 | Ahmet U. Demircioglu | Internal Medicine | 2000 E Layton Ave Ste 170, St Francis, WI 53235-6055 | 2006-11-01 |
| 1235229568 | Mary Parish Gavinski | Internal Medicine | 205 Bishops Way, Brookfield, WI 53005-6247 | 2006-10-16 |
| 1831200781 | In-your-home Medicine & Geriatrics | Internal Medicine | 3915 N Ridgefield Cir, Shorewood, WI 53211-2451 | 2006-08-31 |
| 1376653261 | Paul Joseph Drinkt | Internal Medicine | N2665 County Rd Qq, Wisconsin Veterans Home, King, WI 54946 | 2006-08-30 |
| 1003882994 | Soryal A Soryal | Internal Medicine | 1020 N 12th St, 3rd Floor, Milwaukee, WI 53233-1308 | 2006-02-28 |
| 1467439729 | Kanwardeep Singh | Internal Medicine | 1155 N Honey Creek Pkwy, Wauwatosa, WI 53213-3189 | 2005-12-28 |
| 1740717198 | Floreta Shapiro | Internal Medicine | Uw Hospitals & Clinics 600 Highland Ave, Madison, WI 53792-8255 | 2017-05-16 |
| 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.