GREEN BAY CHEST AND INFECTIOUS DISEASES SC (NPI# 1538356985) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538356985 |
| Entity Type | Organization |
| Organization Name | GREEN BAY CHEST AND INFECTIOUS DISEASES SC |
| Practice Address |
704 S Webster Ave Suite 102 Green Bay WI 54301-3528 |
| Practice Telephone | 9204337516 |
| Practice Fax Number | 9204337464 |
| Mailing Telephone | 9204337516 |
| Mailing Fax Number | 9204337464 |
| Enumeration Date | 2007-10-01 |
| Last Update Date | 2007-10-12 |
| Authorized Official Name | DR. RONALD DALE DAVIS (PRESIDENT) |
| Authorized Official Telephone | 9204337516 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RP1001X |
Internal Medicine Specialization: Pulmonary Disease |
30054 | WI | Allopathic & Osteopathic Physicians |
| Street Address |
704 S WEBSTER AVE SUITE 102 |
| City | GREEN BAY |
| State | WI |
| Zip Code | 54301-3528 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932102787 | Pamela C Baeten | Internal Medicine | 704 S Webster Ave, Ste 500, Green Bay, WI 54301-3528 | 2005-05-24 |
| 1164959680 | Cynthia L Suplinski | Nurse Practitioner | 704 S Webster Ave, Green Bay, WI 54301-3528 | 2017-05-15 |
| 1073063681 | Bellin Memorial Hospital Inc | Internal Medicine | 704 S Webster Ave, Suite 501, Green Bay, WI 54301-3528 | 2016-10-06 |
| 1265986731 | Susan Molenaar | Nurse Practitioner | 704 S Webster Ave, Green Bay, WI 54301-3528 | 2016-08-12 |
| 1225403157 | Bonnie L Dejardin | Nurse Practitioner | 704 S Webster Ave, Green Bay, WI 54301-3528 | 2015-12-03 |
| 1437531720 | Bellin Memorial Hospital Inc | Obstetrics & Gynecology | 704 S Webster Ave, Suite 100 A, Green Bay, WI 54301-3533 | 2015-06-23 |
| 1841672516 | Bellin Memorial Hospital Inc | Obstetrics & Gynecology | 704 S Webster Ave, Suite 100 B, Green Bay, WI 54301-3533 | 2015-06-18 |
| 1407295389 | Michael Chistopher Popelars | Dentist | 704 S Webster Ave, Suite 402, Green Bay, WI 54301-3528 | 2013-06-24 |
| 1013350958 | New Dermatology Group Ltd | Dermatology | 704 S Webster Ave, Green Bay, WI 54301-3528 | 2013-04-10 |
| 1235444225 | Melissa A Anderson | Nurse Practitioner | 704 S Webster Ave, Suite 300, Green Bay, WI 54301-3528 | 2010-08-13 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386102465 | Parc Village Dental, LLC | Dentist | 2805 Libal Street, Suite A, Green Bay, WI 54301 | 2019-03-07 |
| 1598229478 | Shaina Marie Conner | Registered Nurse | 835 S Vanburen St, Green Bay, WI 54301 | 2019-01-25 |
| 1093298960 | Brown County | Case Management | 111 N. Jefferson Street, Green Bay, WI 54301 | 2018-09-07 |
| 1639609928 | Frontline Healthcare LLC | Specialist/Technologist, Other | 2221 S. Webster Ave. Suite 270, Greenbay, WI 54301 | 2017-06-19 |
| 1992242606 | Charmaine Rimple | Counselor | 526 South Monroe Avenue, Green Bay, WI 54301 | 2017-01-20 |
| 1962944819 | Rebecca Lucille Reinbold | Registered Nurse | 917 Catherine Street, Green Bay, WI 54301 | 2016-11-09 |
| 1730635061 | Melissa Kristof | Specialist/Technologist, Other | 1821 Sounth Webster Ave., Green Bay, WI 54301 | 2016-08-28 |
| 1255709747 | Vivian Sweetheart Bishop-cook | Counselor | 2920 South Webster Ave, Green Bay, WI 54301 | 2015-09-14 |
| 1881079960 | Chelsi S Weber | Registered Nurse | 2300 Riverside Dr., Ste 204, Green Bay, WI 54301 | 2015-07-30 |
| 1962816371 | Joelle M Hesse | Counselor | 630 Cherry St., Green Bay, WI 54301 | 2014-06-13 |
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| Taxonomy Code | 207RP1001X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Pulmonary Disease |
| An internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs. |
| 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 |
|---|---|---|---|---|
| 1225317399 | Musab Em T Nusrat | Internal Medicine | 1821 S Webster Ave, Green Bay, WI 54301-2253 | 2011-08-08 |
| 1033420922 | Suraj Arora | Internal Medicine | 2845 Greenbrier Rd, Green Bay, WI 54311-6519 | 2010-06-25 |
| 1922114768 | James P Gapinski | Internal Medicine | 2845 Greenbrier Rd, #120, Green Bay, WI 54308-8900 | 2006-08-22 |
| 1124044813 | Richard Glen Potts | Internal Medicine | 835 S Van Buren St, Green Bay, WI 54301-3526 | 2006-07-14 |
| 1093731382 | Manar Khaled Alshahrouri | Internal Medicine | 1821 S Webster Ave, Green Bay, WI 54301-2253 | 2006-07-14 |
| 1780609073 | John Frederick Andrews | Internal Medicine | 1821 S Webster Ave, Green Bay, WI 54301-2253 | 2006-07-13 |
| 1619903218 | Raul Mendoza-ayala | Internal Medicine | 2845 Greenbrier Rd, Green Bay, WI 54311-6519 | 2006-06-24 |
| 1548223464 | Christian F Maluf | Internal Medicine | 744 S Webster Ave, Green Bay, WI 54301-3505 | 2006-04-11 |
| 1316909047 | New Pulmonary & Sleep Associates | Internal Medicine | 744 S Webster Ave, Green Bay, WI 54301-3505 | 2006-04-06 |
| 1477525350 | Ramana R Marada | Internal Medicine | 2845 Greenbrier Rd, Green Bay, WI 54311-6519 | 2006-02-03 |
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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.