DR. ERIC L. JENISON (NPI# 1669477071) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669477071 |
| Entity Type | Individual |
| Full Name | DR. ERIC L. JENISON |
| Credential | M.D. |
| Practice Address |
704 S Webster Ave Suite 100 Green Bay WI 54301-3528 |
| Mailing Address |
Po Box 22487 Green Bay WI 54305-2487 |
| Practice Telephone | 9204333430 |
| Practice Fax Number | 9204326313 |
| Mailing Telephone | 9204457210 |
| Mailing Fax Number | 9204457289 |
| Enumeration Date | 2005-06-14 |
| Last Update Date | 2014-09-18 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207V00000X | Obstetrics & Gynecology | 038252 | OH | Allopathic & Osteopathic Physicians |
| Y | 207VX0201X |
Obstetrics & Gynecology Specialization: Gynecologic Oncology |
59856 | WI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | 0288531 | 05 | |
| WI | 1669477071 | 05 |
| Street Address |
704 S WEBSTER AVE SUITE 100 |
| 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 |
| Find all providers in the same location | ||||
| 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 |
| Find all providers in zip 54301 | ||||
| Taxonomy Code | 207VX0201X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| Specialization | Gynecologic Oncology |
| An obstetrician/gynecologist who provides consultation and comprehensive management of patients with gynecologic cancer, including those diagnostic and therapeutic procedures necessary for the total care of the patient with gynecologic cancer and resulting complications. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992735534 | Jennifer Morris Rhode | Obstetrics & Gynecology | 704 S Webster Ave Ste 300, Green Bay, WI 54301-3528 | 2006-07-03 |
| 1437531720 | Bellin Memorial Hospital Inc | Obstetrics & Gynecology | 704 S Webster Ave, Suite 100 A, Green Bay, WI 54301-3533 | 2015-06-23 |
| 1285997239 | Nitin A Wadhwa | Obstetrics & Gynecology | 2845 Greenbrier Rd, Green Bay, WI 54311-6519 | 2012-06-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093039869 | Brooke A Schlappe | Obstetrics & Gynecology | 8905 W Lincoln Ave Ste 401, West Allis, WI 53227 | 2010-03-22 |
| 1235124066 | John Charles Rogers | Obstetrics & Gynecology | 3738 S 60th St, Ste 102, Milwaukee, WI 53220-1935 | 2005-09-19 |
| 1124020540 | Scott A Kamelle | Obstetrics & Gynecology | 2801 W. Kinnickinnic River Pkwy, Suite 525, Milwaukee, WI 53215 | 2005-08-15 |
| 1790227940 | Bellin Memorial Hospital Inc | Obstetrics & Gynecology | 2500 E Capitol Dr, Appleton, WI 54911-8735 | 2016-11-04 |
| 1528413762 | Ran Zhang | Obstetrics & Gynecology | 600 Highland Ave, Madison, WI 53792-0001 | 2016-04-25 |
| 1518385244 | Janelle Sobecki Rausch | Obstetrics & Gynecology | Uw Hospitals & Clinics 600 Highland Ave, Madison, WI 53792-2909 | 2014-03-31 |
| 1407168602 | Sumer Kay Wallace | Obstetrics & Gynecology | 600 Highland Ave, Madison, WI 53792-0001 | 2010-07-06 |
| 1851612659 | Erin Bishop | Obstetrics & Gynecology | 9200 W Wisconsin Ave, Gynecologic Oncology, Milwaukee, WI 53226-3522 | 2010-06-15 |
| 1952538001 | Joseph John Weber | Obstetrics & Gynecology | 2801 W Kinnickinnic River Pkwy, Aurora Medical Group Ste 165, Milwaukee, WI 53215-3669 | 2009-06-16 |
| 1578739090 | William Hampton Bradley | Obstetrics & Gynecology | 9200 W Wisconsin Ave, Milwaukee, WI 53226-3522 | 2008-05-05 |
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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.