JON T MOEN (NPI# 1538141742) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538141742 |
| Entity Type | Individual |
| Full Name | JON T MOEN |
| Credential | MD |
| Practice Address |
421 Camelot Dr Fond Du Lac WI 54935-8335 |
| Mailing Address |
420 E Division St Fond Du Lac WI 54935-4560 |
| Practice Telephone | 9209265760 |
| Mailing Telephone | 9209268340 |
| Mailing Fax Number | 9209268370 |
| Enumeration Date | 2005-11-15 |
| Last Update Date | 2016-03-02 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208600000X | Surgery | 27281 | WI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | RAILROAD MEDICARE | 020028611 | 01 |
| WI | 020028611 | 05 |
| Street Address |
421 CAMELOT DR |
| City | FOND DU LAC |
| State | WI |
| Zip Code | 54935-8335 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366433435 | Elizabeth S Bensen | Physical Medicine & Rehabilitation | 421 Camelot Dr, Fond Du Lac, WI 54935-8335 | 2005-10-28 |
| 1962028522 | Kelley Cantu | Massage Therapist | 421 Camelot Dr, Fond Du Lac, WI 54935-8335 | 2020-06-19 |
| 1306473780 | Samantha Jo Krones | Physician Assistant | 421 Camelot Dr, Fond Du Lac, WI 54935-8335 | 2020-03-25 |
| 1962975292 | Tyler Schwarz | Specialist/Technologist | 421 Camelot Dr, Fond Du Lac, WI 54935-8335 | 2019-01-09 |
| 1154808491 | Greta Marie Breckbill | Audiologist | 421 Camelot Dr, Fond Du Lac, WI 54935 | 2018-07-19 |
| 1861991424 | Jacklyn Osborne | Nurse Practitioner | 421 Camelot Dr, Fond Du Lac, WI 54935-8335 | 2018-02-08 |
| 1932620689 | Michael Schraufnagel | Physical Therapist | 421 Camelot Dr, Fond Du Lac, WI 54935-8335 | 2017-07-03 |
| 1477083608 | Tristan G Brown | Optometrist | 421 Camelot Dr, Fond Du Lac, WI 54935-8335 | 2017-06-20 |
| 1306379433 | Ashley Beyer | Specialist/Technologist | 421 Camelot Dr, Fond Du Lac, WI 54935-8335 | 2017-04-05 |
| 1417498254 | Allieson Elizabeth Mirsberger | Massage Therapist | 421 Camelot Dr, Fond Du Lac, WI 54935-8335 | 2017-03-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609482249 | Keziah Sherri Love | Counselor | W390 Wi-23, Fond Du Lac, WI 54935 | 2020-09-18 |
| 1891341988 | Cynthia Louise Singleton | Nurse Practitioner | 16 E 13th St., Fond Du Lac, WI 54935 | 2019-08-14 |
| 1083183297 | Elena Alexandra Giese | Nurse Practitioner | 430 E. Division St, Fond Du Lac, WI 54935 | 2018-11-16 |
| 1669963740 | Elizabeth Anne Machi | Student in an Organized Health Care Education/Training Program | 885 Western Ave Ste 300, Fond Du Lac, WI 54935 | 2018-05-23 |
| 1184150021 | Jordan Moehn | Specialist/Technologist | 633 Prairie Pkwy, Fond Du Lac, WI 54935 | 2017-05-11 |
| 1467856336 | Chuentao Ho | Specialist/Technologist | 45 South National Ave., Fond Du Lac, WI 54935 | 2014-10-21 |
| 1437587961 | Paula Seeley | Nurse Practitioner | 63 West Pioneer Rd, Fond Du Lac, WI 54935 | 2013-10-18 |
| 1144516030 | Bonnie Kay Mallon | Registered Nurse | 118 E 9th St, Fond Du Lac, WI 54935 | 2011-06-20 |
| 1770885600 | Holly Shepard | Counselor | 23 W Scott St., Fond Du Lac, WI 54935 | 2010-11-29 |
| 1437479110 | Ruth Marie Bohn | Occupational Therapy Assistant | 244 North Macy Street, Fond Du Lac, WI 54935 | 2010-06-04 |
| Find all providers in zip 54935 | ||||
| Taxonomy Code | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891081360 | Anthony Joseph Herrera | Surgery | 210 Wisconsin American Dr, Fond Du Lac, WI 54937-2999 | 2011-06-23 |
| 1487958765 | Fountain City Surgical Associates | Surgery | 210 Wisconsin American Dr, Fond Du Lac, WI 54937-2999 | 2010-12-31 |
| 1144382656 | Christopher A Nervi | Surgery | 420 E Division St, Fond Du Lac, WI 54935-4560 | 2006-12-14 |
| 1700954682 | Joanne F Pasiuk | Surgery | 420 E Division St, Fond Du Lac, WI 54935-4560 | 2006-12-01 |
| 1831175546 | Thomas J Carlson | Surgery | 145 N Main St, Fond Du Lac, WI 54935-3423 | 2005-12-15 |
| 1871576769 | Steven M Cahee | Surgery | 420 E Division St, Fond Du Lac, WI 54935-4560 | 2005-11-23 |
| 1962484568 | Toni L Stanley | Surgery | 420 E Division St, Fond Du Lac, WI 54935-4560 | 2005-11-18 |
| 1851373641 | Robert H Mikkelsen | Surgery | 420 E Division St, Fond Du Lac, WI 54935-4560 | 2005-11-16 |
| 1649263989 | Donald F Vanbeek | Surgery | 210 Wisconsin American Dr, Ste #265, Fond Du Lac, WI 54935-2999 | 2005-08-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598310195 | Matthew Laviolette | Surgery | Medical College of Wisconsin, 8701 Watertown Plank Rd., Surgical Oncology, Milwaukee, WI 53226 | 2019-08-09 |
| 1659832855 | Benjamin David Seadler | Surgery | Mcw, Department of Surgery, 8701 Watertown Plank Road, Milwaukee, WI 53226 | 2019-03-29 |
| 1861969149 | Watertown Physician Practices LLC | Surgery | 123 Hospital Dr Ste 2009, Watertown, WI 53098-3320 | 2018-10-25 |
| 1356847644 | Laura K Krecko | Surgery | Uw Hospital and Clinics 600 Highland Avenue, Madison, WI 53792-0001 | 2018-04-04 |
| 1447785332 | Patrick Beard Schwartz | Surgery | Uw Hopsitals and Clinics, 600 Highland Ave., Madison, WI 53792-0001 | 2017-04-27 |
| 1700263720 | Marianna Dubovska | Surgery | 902 Riverside Dr Ste 201, Waupaca, WI 54981-1992 | 2015-04-28 |
| 1366833394 | Beaver Dam Community Hospitals, Inc | Surgery | 705 S University Ave Ste 350, Beaver Dam, WI 53916 | 2015-02-12 |
| 1972901262 | The Healthy Vein, Sc | Surgery | N79w14684 Appleton Ave, Menomonee Falls, WI 53051-4308 | 2014-12-18 |
| 1326453200 | Chey V Collura | Surgery | 2700 W 9th Ave Ste 310, Oshkosh, WI 54904 | 2014-06-30 |
| 1538570338 | Nicholas Sich | Surgery | 2901 W Kinnickinnic River Pkwy Dept Ste 540, Milwaukee, WI 53215-3677 | 2014-05-14 |
| Find all providers with the same taxonomy | ||||
| City | FOND DU LAC |
| Zip Code | 54935 |
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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.