MARK HALLETT (NPI# 1629098504) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629098504 |
| Entity Type | Individual |
| Full Name | MARK HALLETT |
| Credential | MD |
| Practice Address |
820 E Grant St Appleton WI 54911-3483 |
| Mailing Address |
Po Box 8003 Appleton WI 54912-8003 |
| Practice Telephone | 9208315050 |
| Mailing Telephone | 9209963298 |
| Mailing Fax Number | 9207385787 |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2011-02-02 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207QS0010X |
Family Medicine Specialization: Sports Medicine |
34228 | WI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 31944600 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972938371 | Mark Anthony Hallett | Occupational Therapy Assistant | 600 Commonwealth Ave, Warwick, RI 02886 | 2013-09-05 |
| 1598841678 | Mark Hallett | Psychiatry & Neurology | 10 Center Dr Msc 1428, Ninds, Nih, Bldg. 10, Rm 5n226, Bethesda, MD 20892-0001 | 2006-10-31 |
| Street Address |
820 E GRANT ST |
| City | APPLETON |
| State | WI |
| Zip Code | 54911-3483 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912993247 | Crystal J Sturgis | Physician Assistant | 820 E Grant St, Appleton, WI 54911-3483 | 2005-09-22 |
| 1932759883 | Kayla Van Handel | Specialist/Technologist | 820 E Grant St, Appleton, WI 54911-3483 | 2019-09-12 |
| 1326600610 | Abby Imelda Kaufman | Specialist/Technologist | 820 E Grant St, Appleton, WI 54911-3483 | 2019-07-08 |
| 1861959371 | Teresa A Mulzer | Nurse Practitioner | 820 E Grant St, Appleton, WI 54911-3483 | 2019-02-21 |
| 1073022356 | Megan Elizabeth Galske | Nurse Practitioner | 820 E Grant St, Appleton, WI 54911-3483 | 2017-09-29 |
| 1609303023 | Monica S Albert | Nurse Practitioner | 820 E Grant St, Appleton, WI 54911-3483 | 2017-05-16 |
| 1366824179 | Stacy Lamae Van Sambeek | Physician Assistant | 820 E Grant St, Appleton, WI 54911-3483 | 2015-06-29 |
| 1023490315 | Katherine K Krause | Physician Assistant | 820 E Grant St, Appleton, WI 54911-3483 | 2015-06-23 |
| 1679969828 | Alisha Beth Lowden | Nurse Practitioner | 820 E Grant St, Appleton, WI 54911-3483 | 2015-04-14 |
| 1083000319 | Matthew John Fischer | Anesthesiology | 820 E Grant St, Appleton, WI 54911-3483 | 2015-04-14 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912545633 | Brotherly Love, LLC | Day Training, Developmentally Disabled Services | 1513 E Frances St, Appleton, WI 54911 | 2019-12-12 |
| 1952952129 | Eagle Point Senior Living Inc | Assisted Living Facility | 995 East John Street, Appleton, WI 54911 | 2019-09-27 |
| 1619524766 | University Rx LLC | Pharmacy | 133 E College Ave, Appleton, WI 54911 | 2019-08-23 |
| 1174080063 | Shayla Russell | Counselor | Outagamie County Health and Human Services, 320 S. Walnut St., Appleton, WI 54911 | 2019-02-27 |
| 1871086645 | Megan Kilsdonk | Health Educator | 1604 N Meade St, Appleton, WI 54911 | 2018-06-07 |
| 1871085480 | Tanya Lynn Vickery | Social Worker | 410 S. Elm St., Appleton, WI 54911 | 2018-05-31 |
| 1013407501 | Teri G Metropulos | Counselor | 229 S. Morrison, Appleton, WI 54911 | 2018-05-10 |
| 1093211211 | Bonnie Anne Korytkowski | Student in an Organized Health Care Education/Training Program | 229 S. Morrison Street, Appleton, WI 54911 | 2018-04-05 |
| 1639673940 | Brett Follett | Psychologist | 401 S. Elm St., Appleton, WI 54911 | 2018-03-21 |
| 1700202892 | Brian Withrow | Counselor | 607 West 7th St., Appleton, WI 54911 | 2014-03-13 |
| Find all providers in zip 54911 | ||||
| Taxonomy Code | 207QS0010X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Specialization | Sports Medicine |
| A family medicine physician that is trained to be responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention of injury and illness. A sports medicine physician must have knowledge and experience in the promotion of wellness and the prevention of injury. Knowledge about special areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation, injuries (treatment and prevention and referral practice) and the role of exercise in promoting a healthy lifestyle are essential to the practice of sports medicine. The sports medicine physician requires special education to provide the knowledge to improve the health care of the individual engaged in physical exercise (sports) whether as an individual or in team participation. |
| 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 Family Medicine, 2007. http://www.theabfm.org/. American Osteopathic Board of Family Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861443608 | Erica L Kroncke | Family Medicine | 820 E Grant St, Appleton, WI 54911-3483 | 2006-05-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811203706 | Matthew M Brown | Family Medicine | 1705 Hoffman St, Madison, WI 53704-2510 | 2010-08-30 |
| 1174764906 | Mark W Niedfeldt, Md, LLC | Family Medicine | 10556 N Port Washington Rd, Ste 101, Mequon, WI 53092-5586 | 2009-03-06 |
| 1225151558 | Patrick Earl Mcdonough | Family Medicine | 235 State Street, St. Croix Falls, WI 54024 | 2007-04-10 |
| 1790858462 | Shanyn Colleen Lancaster | Family Medicine | 1250 W Wisconsin Ave, Student Health, Schroeder Complex, Lower Level, Milwaukee, WI 53233-2225 | 2006-11-17 |
| 1306919907 | Steven Alan Giles | Family Medicine | 3316 Ridgeline Dr, Waukesha, WI 53188 | 2006-11-15 |
| 1689220527 | Delo Sport and Stem Sc | Family Medicine | 2595 Development Dr Ste 140, Green Bay, WI 54311-4267 | 2019-08-15 |
| 1417377755 | Todd Domeyer | Family Medicine | 3113 Saemann Ave, Sheboygan, WI 53081 | 2014-04-25 |
| 1972949501 | Chad Joseph Giles | Family Medicine | 4100 State Highway 66, Stevens Point, WI 54482 | 2013-05-22 |
| 1073956363 | Lucianne Helena Olewinski | Family Medicine | Uw Hospital and Clinics, 600 Highland Ave, Madison, WI 53792-0001 | 2013-04-17 |
| 1902166978 | Jessica L Juntunen | Family Medicine | 5200 Hummingbird Rd, Suite 100, Wausau, WI 54401-6312 | 2012-05-23 |
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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.