JOHN WILLIAM RAFFERTY (NPI# 1669460671) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669460671 |
| Entity Type | Individual |
| Full Name | JOHN WILLIAM RAFFERTY |
| Credential | C.R.N.A. |
| Practice Address |
420 E Division St Fond Du Lac WI 54935 |
| Mailing Address |
420 E Division St Fond Du Lac WI 54935-4560 |
| Practice Telephone | 9209292300 |
| Mailing Telephone | 9209268340 |
| Mailing Fax Number | 9209268370 |
| Enumeration Date | 2005-10-12 |
| Last Update Date | 2018-07-27 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163W00000X | Registered Nurse | R140619-5 | MN | Nursing Service Providers |
| Y | 367500000X | Nurse Anesthetist, Certified Registered | 7287 | WI | Physician Assistants & Advanced Practice Nursing Providers |
| N | 367500000X | Nurse Anesthetist, Certified Registered | 722008 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | TRICARE | 742682282 | 01 |
| TX | MEDICARE RAILROAD | CS7984 | 01 |
| TX | 175220601 | 05 | |
| TX | 175220602 | 05 | |
| TX | FED WORKERS COMPENSATION | 177403203 | 01 |
| TX | FED WORKERS COMPENSATION | 177403205 | 01 |
| TX | BCBS | 00C34S | 01 |
| TX | FED WORKERS COMPENSATION | 177403202 | 01 |
| TX | FED WORKERS COMPENSATION | 177403201 | 01 |
| TX | FED WORKERS COMPENSATION | 177403204 | 01 |
| TX | 083801302 | 05 | |
| TX | BCBS | 85328U | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386294684 | John Rafferty | Registered Nurse | 100 Community Dr, Tobyhanna, PA 18466-8985 | 2019-09-18 |
| 1912423617 | John Rafferty | Social Worker | 2090 Adam Clayton Powell Jr. Blvd, New York, NY 10027-9853 | 2017-08-15 |
| Street Address |
420 E DIVISION ST |
| City | FOND DU LAC |
| State | WI |
| Zip Code | 54935 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760489017 | Ronald Eric Lilly | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 420 E Division St, Fond Du Lac, WI 54935-4560 | 2005-07-01 |
| 1831715721 | Agnesian Healthcare Inc | Preventive Medicine | 420 E Division St, Fond Du Lac, WI 54935-4560 | 2020-06-17 |
| 1336783042 | Lisa Jo Liedke | Nurse Practitioner | 420 E Division St, Fond Du Lac, WI 54935-4560 | 2019-11-05 |
| 1932740495 | Terrina Kay Goeden | Nurse Practitioner | 420 E Division St, Fond Du Lac, WI 54935-4560 | 2019-10-04 |
| 1801441910 | Courtney M Yenter | Nurse Practitioner | 420 E Division St, Fond Du Lac, WI 54935-4560 | 2019-08-06 |
| 1861046591 | Kimberly Kay Hornes | Nurse Practitioner | 420 E Division St, Fond Du Lac, WI 54935-4560 | 2019-07-31 |
| 1023662459 | Domenick Tirabassi Iv | Student in an Organized Health Care Education/Training Program | 420 E Division St, Fond Du Lac, WI 54935-4560 | 2019-07-24 |
| 1497308233 | Kelly Jo Rehfeldt | Nurse Practitioner | 420 E Division St, Fond Du Lac, WI 54935-4560 | 2019-07-22 |
| 1184286411 | Carley Jo Reinke | Nurse Practitioner | 420 E Division St, Fond Du Lac, WI 54935-4560 | 2019-07-08 |
| 1255823316 | Teegan R Kraus | Physician Assistant | 420 E Division St, Fond Du Lac, WI 54935 | 2018-06-05 |
| 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 | 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 |
|---|---|---|---|---|
| 1609904689 | James G Vanbommel | Nurse Anesthetist, Certified Registered | 259 N Park Ave, Fond Du Lac, WI 54935-3540 | 2007-03-01 |
| 1437157831 | Gilberto Cantu | Nurse Anesthetist, Certified Registered | 430 E Division St, Fond Du Lac, WI 54935-4560 | 2005-07-09 |
| 1891176152 | Brittney Iturrizaga | Nurse Anesthetist, Certified Registered | 430 E Division St, Fond Du Lac, WI 54935-4560 | 2015-06-12 |
| 1235417320 | Kelly Mukti Olsen | Nurse Anesthetist, Certified Registered | 430 E Division St, Fond Du Lac, WI 54935-4560 | 2011-07-24 |
| 1457487092 | Gabriel Charles Leis | Nurse Anesthetist, Certified Registered | 420 E Division St, Fond Du Lac, WI 54935-4560 | 2007-02-26 |
| 1306951496 | William J Garske Jr | Nurse Anesthetist, Certified Registered | 210 Wisconsin American Dr, Fond Du Lac, WI 54935 | 2006-08-20 |
| 1477521375 | Steven J. Feit | Nurse Anesthetist, Certified Registered | 430 E Division St, Fond Du Lac, WI 54935-4560 | 2006-03-08 |
| 1033195763 | Carol A Craig | Nurse Anesthetist, Certified Registered | 430 E Division St, Fond Du Lac, WI 54935-4560 | 2005-12-15 |
| 1699751305 | Linda A Welch | Nurse Anesthetist, Certified Registered | 430 E Division St, Suite 4, Fond Du Lac, WI 54935-4560 | 2005-12-15 |
| 1336125053 | Wendy E Wiese | Nurse Anesthetist, Certified Registered | 430 E Division St, Suite 4, Fond Du Lac, WI 54935-4560 | 2005-12-15 |
| Find all providers in FOND DU LAC | ||||
| 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.