KAGEN DERMATOLOGY CLINIC SC (NPI# 1730238890) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730238890 |
| Entity Type | Organization |
| Organization Name | KAGEN DERMATOLOGY CLINIC SC |
| Practice Address |
100 W Lawrence St Suite 409 Appleton WI 54911-5773 |
| Practice Telephone | 9207335138 |
| Practice Fax Number | 9207333759 |
| Mailing Telephone | 9207335138 |
| Mailing Fax Number | 9207333759 |
| Enumeration Date | 2007-01-09 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. CHARLES NORMAN KAGEN (PHYSICIAN) |
| Authorized Official Telephone | 9207335138 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | 24388 | WI | Other Service Providers |
| Street Address |
100 W LAWRENCE ST SUITE 409 |
| City | APPLETON |
| State | WI |
| Zip Code | 54911-5773 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235175589 | Steven L Kagen | Allergy & Immunology | 100 W Lawrence St, Appleton, WI 54911-5773 | 2006-06-22 |
| 1770843260 | The Kagen Allergy Clinic Sc | Allergy & Immunology | 100 W Lawrence St, Appleton, WI 54911-5773 | 2012-05-18 |
| 1205993946 | Kagen Allergy Clinic S.c. | Allergy & Immunology | 100 W Lawrence St, Appleton, WI 54911-5773 | 2007-01-02 |
| 1114015674 | Charles Norman Kagen | Dermatology | 100 W Lawrence St, Suite 409, Appleton, WI 54911-5773 | 2006-10-10 |
| 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 | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316068091 | Cathy M Olson | Specialist | 3305c North Ballard Rd., Appleton, WI 54911-9001 | 2007-04-02 |
| 1265490437 | Timothy Ivan Zuck | Specialist | 5395 Michaels Dr, Appleton, WI 54913-8447 | 2006-05-03 |
| 1699777144 | Mark John Scherer | Specialist | 610 E Longview Dr, Appleton, WI 54911-2149 | 2005-08-15 |
| 1679948566 | Padraic Obma, M.d., S.c. | Specialist | 2105 E Enterprise Ave, Suite 112, Appleton, WI 54913-7862 | 2015-12-03 |
| 1881077295 | Kayla B Schneider | Specialist | 2105 E Enterprise Ave Ste 113, Appleton, WI 54913-7862 | 2015-07-02 |
| 1144570870 | Kenneth L. Schaufelberger, M.d., S.c. | Specialist | 2105 E Enterprise Ave, Appleton, WI 54913-7862 | 2012-09-10 |
| 1366745804 | Kristin Nicole Wallace | Specialist | 1506 S Oneida St, Appleton, WI 54915-1305 | 2010-12-06 |
| 1043461460 | Fox Valley Gastroenterology, S.c. | Specialist | 900 E Grant St, Appleton, WI 54911-3487 | 2008-10-03 |
| 1265590848 | Fox Valley Pulmonary Medicine, LLC | Specialist | 820 E Grant St, Suite S 250, Appleton, WI 54911-3483 | 2006-12-05 |
| 1063521714 | Lee W Hash | Specialist | 1531 S Madison St, Appleton, WI 54915-1800 | 2006-08-29 |
| Find all providers in APPLETON | ||||
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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.