REBECCA B MAUCK (NPI# 1629219944) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629219944 |
| Entity Type | Individual |
| Full Name | REBECCA B MAUCK |
| Credential | CRNA |
| Practice Address |
6308 8th Ave Kenosha WI 53143 |
| Mailing Address |
Po Box 7096 Stockton CA 95267-0096 |
| Practice Telephone | 2626562011 |
| Mailing Telephone | 2099567725 |
| Enumeration Date | 2009-03-17 |
| Last Update Date | 2018-09-06 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163W00000X | Registered Nurse | RN160242 | AZ | Nursing Service Providers |
| N | 163W00000X | Registered Nurse | 165541 | WI | Nursing Service Providers |
| Y | 367500000X | Nurse Anesthetist, Certified Registered | CRNA0645 | AZ | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 8901 E Raintree Dr Ste 100, Scottsdale, AZ 85260 | 4807672100 |
| Street Address |
6308 8TH AVE |
| City | KENOSHA |
| State | WI |
| Zip Code | 53143 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366440851 | Janet S Barney | Nurse Practitioner | 6308 8th Ave, Suite 2000, Kenosha, WI 53143-5031 | 2005-07-08 |
| 1669094165 | Simona Slavinskiene | Nurse Practitioner | 6308 8th Ave, Kenosha, WI 53143-5031 | 2020-05-07 |
| 1366063133 | Lisa Neyens | Pharmacist | 6308 8th Ave, Kenosha, WI 53143-5031 | 2020-05-02 |
| 1164056727 | Michael James Church | Physician Assistant | 6308 8th Ave, Kenosha, WI 53143-5031 | 2020-02-23 |
| 1215593009 | Ihc-wound Care Services LLC | Emergency Medicine | 6308 8th Ave, Kenosha, WI 53143-5031 | 2019-05-16 |
| 1609358357 | Samantha M Rhodes | Physical Therapist | 6308 8th Ave, Kenosha, WI 53143-5031 | 2018-08-29 |
| 1063953784 | Megan Roethle | Registered Nurse | 6308 8th Ave, Kenosha, WI 53143-5031 | 2017-03-14 |
| 1043678683 | Sarah Rens | Physician Assistant | 6308 8th Ave, Kenosha, WI 53143-5031 | 2016-02-09 |
| 1922472422 | Catherine A Hernandez | Physician Assistant | 6308 8th Ave, Kenosha, WI 53143-5031 | 2015-11-20 |
| 1750779856 | Elliot M Simon | Physician Assistant | 6308 8th Ave, Suite 1020, Kenosha, WI 53143-5031 | 2014-12-26 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891262275 | Shanda L Goecks | Registered Nurse | 6916 26th Ave, Kenosha, WI 53143 | 2018-10-24 |
| 1689942989 | Racine Kenosha Community Action Agency | Public Health or Welfare | 2000 63rd Street, Kenosha, WI 53143 | 2011-12-01 |
| 1538497797 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 7525 Sheridan Rd, Kenosha, WI 53143 | 2009-11-30 |
| 1497929012 | Ebba M Johnson | Physical Therapist | 524 74th Street, Kenosha, WI 53143 | 2008-04-15 |
| 1770789489 | Kenosha Community Health Center, Inc | Family Medicine | 6226 14th Ave, Kenosha, WI 53143 | 2007-06-21 |
| 1558413161 | Junith M Thompson | Obstetrics & Gynecology | 6530 Sheridan Road, Kenosha, WI 53143 | 2007-01-17 |
| 1154471332 | Ljh Ambulance, Inc | Ambulance | 6329 28th Ave, Kenosha, WI 53143 | 2007-01-11 |
| 1578625794 | Michael A Schellpfeffer Md Ob Gyn Sc | Obstetrics & Gynecology | 1400 75th Street, Kenosha, WI 53143 | 2006-12-14 |
| 1457468654 | Yasmine S Sido | Physician Assistant | 7550 22nd Ave, Kenosha, WI 53143 | 2006-08-24 |
| 1356307359 | Nancy Jane Houtchens | Dentist | 7533 22nd Ave, Ste 100, Kenosha, WI 53143 | 2006-04-26 |
| Find all providers in zip 53143 | ||||
| Taxonomy Code | 367500000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Anesthetist, Certified Registered |
| (1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of credentials and state licensure review and a national examination directed by the Council on Certification of Nurse Anesthetists. (2) A registered nurse who is qualified by special training to administer anesthesia in collaboration with a physician or dentist and who can assist in the care of patients who are in critical condition. |
| Notes: Sources: (1) Council on Certification of Nurse Anesthetists, Park Ridge, IL, and Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. (2) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 548. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225417488 | Jessica L Holland | Nurse Anesthetist, Certified Registered | 10400 75th St, Kenosha, WI 53142 | 2015-05-21 |
| 1205233467 | Alexandra M Roznowski | Nurse Anesthetist, Certified Registered | 10400 75th St, Kenosha, WI 53142-7884 | 2014-12-03 |
| 1669802492 | Brandi M Turner | Nurse Anesthetist, Certified Registered | 10400 75th St, Kenosha, WI 53142-7884 | 2013-11-14 |
| 1184987240 | Hannah R Stewart | Nurse Anesthetist, Certified Registered | 10400 75th St, Kenosha, WI 53142-7884 | 2012-06-22 |
| 1174709919 | David Shannon Cadell | Nurse Anesthetist, Certified Registered | 6308 8th Ave, Kenosha, WI 53143 | 2008-01-10 |
| 1275518276 | Theresa A. Aschenbrener | Nurse Anesthetist, Certified Registered | 6308 8th Ave, Kenosha, WI 53143-5031 | 2005-12-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154943637 | Michael Poeschel | Nurse Anesthetist, Certified Registered | 2109 E Capitol Dr Ste B, Appleton, WI 54911-8726 | 2020-05-07 |
| 1285148643 | River Valley Anesthesia, Inc. | Nurse Anesthetist, Certified Registered | 130 S. Knowles Ave., New Richmond, WI 54017 | 2017-11-21 |
| 1295278356 | Braden Williams | Nurse Anesthetist, Certified Registered | 955 Pheasant Creek Dr, Oshkosh, WI 54904 | 2016-11-22 |
| 1396287447 | Dee Cha | Nurse Anesthetist, Certified Registered | 4851 Rachel Ln Apt 5, Wausau, WI 54401 | 2016-11-07 |
| 1053790972 | Rest Assured Anesthesia Services LLC | Nurse Anesthetist, Certified Registered | 1200 John Q Hammons Dr Ste 102, Madison, WI 53717-1967 | 2015-05-26 |
| 1205223898 | Petagaye Tm Johnson | Nurse Anesthetist, Certified Registered | 5150 E Cheryl Pkwy Unit 301, Fitchburg, WI 53711-7659 | 2015-04-21 |
| 1568851194 | Nicholas Joseph Nuccio | Nurse Anesthetist, Certified Registered | 720 S Marquette St, #302, Racine, WI 53403-1174 | 2015-01-20 |
| 1285030452 | Garner Anesthesia Services LLC | Nurse Anesthetist, Certified Registered | 254 E Marquette St, Berlin, WI 54923-1298 | 2014-11-14 |
| 1073934048 | Lynne M Krebs Crna Sc | Nurse Anesthetist, Certified Registered | W178n9912 Rivercrest Dr Ste 102, Germantown, WI 53022-4645 | 2013-12-18 |
| 1831537679 | Roxanne Brault | Nurse Anesthetist, Certified Registered | 7929 S 66th St, Franklin, WI 53132-9281 | 2013-06-13 |
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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.