KRISTIN JANNA MAGLIOCCO (NPI# 1679004980) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679004980 |
| Entity Type | Individual |
| Full Name | KRISTIN JANNA MAGLIOCCO |
| Credential | MD |
| Practice Address |
2311 N Prospect Ave Milwaukee WI 53211-4445 |
| Practice Telephone | 4143193000 |
| Mailing Telephone | 4143193000 |
| Enumeration Date | 2017-03-27 |
| Last Update Date | 2020-08-11 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 70159 | WI | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
2311 N PROSPECT AVE |
| City | MILWAUKEE |
| State | WI |
| Zip Code | 53211-4445 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710983275 | James G Linn | Obstetrics & Gynecology | 2311 N Prospect Ave, Milwaukee, WI 53211-4445 | 2005-06-21 |
| 1235752353 | Maria Michelle Olex | Psychologist | 2311 N Prospect Ave, Milwaukee, WI 53211-4445 | 2020-05-22 |
| 1336785500 | Daniel Steven Chadwick | Physician Assistant | 2311 N Prospect Ave, Milwaukee, WI 53211-4445 | 2019-11-22 |
| 1154978310 | Linda Perez | Nurse Practitioner | 2311 N Prospect Ave, Milwaukee, WI 53211-4445 | 2019-08-22 |
| 1497228274 | Megan T Snyder | Registered Nurse | 2311 N Prospect Ave, Milwaukee, WI 53211-4445 | 2019-01-04 |
| 1477026185 | Gina Marie Hubacz | Nurse Practitioner | 2311 N Prospect Ave, Milwaukee, WI 53211-4445 | 2019-01-04 |
| 1730659343 | Lindsay Marie Witkowski | Nurse Practitioner | 2311 N Prospect Ave, Milwaukee, WI 53211-4445 | 2018-11-27 |
| 1811428303 | Bernard Nartey | Family Medicine | 2311 N Prospect Ave, Milwaukee, WI 53211-4445 | 2017-03-25 |
| 1699125385 | Lena Sharma | Family Medicine | 2311 N Prospect Ave, Milwaukee, WI 53211 | 2016-06-14 |
| 1962851972 | Sarada Abraham | Family Medicine | 2311 N Prospect Ave, Milwaukee, WI 53211-4445 | 2016-06-09 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821602335 | Gabriella Caitrin Emanuele | Occupational Therapist | Harborchase of Shorewood, 1111 E Capitol Drive, Shorewood, WI 53211 | 2020-09-02 |
| 1710527783 | Sage Specialty Pharmacy Inc. | Pharmacy | 4001 N. Oakland Ave, Shorewood, WI 53211 | 2020-01-08 |
| 1861043952 | Rosina Bloomingdale Norton | Nurse Practitioner | 1921 E Harford Ave, Milwaukee, WI 53211 | 2019-09-20 |
| 1528556255 | Renee Reckelberg | Specialist/Technologist | 3409 North Downer Avenue, Pavilion, Suite 350, Milwaukee, WI 53211 | 2018-04-27 |
| 1700325602 | Wisconsin Vision, Inc. | Optometrist | 4163 N Oakland Ave, Shorewood, WI 53211 | 2017-02-13 |
| 1750827556 | Daniel Butz M.d., S.c. | Plastic Surgery | 2350 N Lake Dr Ste 304, Milwaukee, WI 53211 | 2017-01-17 |
| 1528517232 | Therese Simonis | Speech-Language Pathologist | 2390 N Lake Drive, Milwaukee, WI 53211 | 2016-09-23 |
| 1982075701 | Katie Michel | Specialist/Technologist | 3409 N. Downer Ave, Milwaukee, WI 53211 | 2015-10-20 |
| 1255776365 | Sarah Elizabeth Brill | Social Worker | 4433 N Oakland Ave Ste D, Shorewood, WI 53211 | 2013-05-02 |
| 1679814537 | Nicole Anne Parulski | Physical Therapist | 2301 North Lake Dr, Milwaukee, WI 53211 | 2013-03-01 |
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| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, 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 Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730679804 | Vicki Milroy | Family Medicine | 2778 S 35th St Ste 102, Milwaukee, WI 53215-3578 | 2018-05-15 |
| 1376050450 | Independent Physicians of Wisconsin, LLC | Family Medicine | 5233 S 27th St, Milwaukee, WI 53221-3764 | 2018-01-10 |
| 1427565548 | Independent Physicians of Wisconsin, LLC | Family Medicine | 3201 S 16th St Ste 2020, Milwaukee, WI 53215-4532 | 2018-01-10 |
| 1962932970 | Mary Kuder | Family Medicine | 176 N Broadway, Milwaukee, WI 53202-6015 | 2017-06-13 |
| 1386178804 | Dane A Olsen | Family Medicine | 801 W Kinnickinnic River Pkwy., Suite 250, Milwaukee, WI 53215 | 2017-04-12 |
| 1598296212 | Leslie J Rabaut | Family Medicine | 2801 W Kk River Pkwy Ste 250, Milwaukee, WI 53215-3678 | 2017-03-23 |
| 1871975920 | Independent Physicians of Wisconsin, LLC | Family Medicine | 5434 W Capitol Dr Ste 3, Milwaukee, WI 53216-2298 | 2015-06-25 |
| 1952717928 | Mobile Medical Clinic, Inc | Family Medicine | 2418 W Edgerton Ave, Milwaukee, WI 53221-3412 | 2014-07-10 |
| 1437572831 | Pathfinder Medical Group | Family Medicine | 216 Milwaukee St, Suite 2d, Milwaukee, WI 53202 | 2014-01-22 |
| 1376897413 | Sandra Kathleen Mahkorn | Family Medicine | 3050 S Superior St, Milwaukee, WI 53207-3064 | 2012-10-26 |
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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.