WENDY P GOLDBACH (NPI# 1740327618) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740327618 |
| Entity Type | Individual |
| Full Name | WENDY P GOLDBACH |
| Credential | OTD MED OTR CHT |
| Practice Address |
12800 N Lake Shore Dr Mequon WI 53097-2418 |
| Mailing Address |
2704 Bible Camp Rd Rhinelander WI 54501 |
| Practice Telephone | 2622434261 |
| Practice Fax Number | 2622434261 |
| Mailing Telephone | (715) 490-2954 |
| Mailing Fax Number | 7152827161 |
| Enumeration Date | 2007-01-31 |
| Last Update Date | 2018-03-17 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 225XH1200X |
Occupational Therapist Specialization: Hand |
1092026 | WI | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | WISCONSIN STATE LICENSE | 1092-26 | 01 |
| WI | 40547700 | 05 | |
| WI | NPI | 1780663013 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 201 Hospital Rd., Eagle River Memorial Hospital, Eagle River, WI 54521 | 7154794711 |
| Street Address |
12800 N LAKE SHORE DR |
| City | MEQUON |
| State | WI |
| Zip Code | 53097-2418 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174636328 | Kemery Jean Sigmund | Specialist/Technologist | 12800 N Lake Shore Dr, Mequon, WI 53097-2418 | 2006-08-15 |
| 1578112520 | Nicole Angela Weber | Student in an Organized Health Care Education/Training Program | 12800 N Lake Shore Dr, Mequon, WI 53097-2418 | 2019-09-11 |
| 1497307649 | Brian Lentz | Specialist/Technologist | 12800 N Lake Shore Dr, Mequon, WI 53097-2418 | 2019-07-09 |
| 1811559131 | Lauren Nikolai | Specialist/Technologist | 12800 N Lake Shore Dr, Mequon, WI 53097-2418 | 2019-07-08 |
| 1962974030 | April F Gotzler | Specialist/Technologist | 12800 N Lake Shore Dr, Mequon, WI 53097-2418 | 2018-12-29 |
| 1518439843 | Concordia University, Inc | General Practice | 12800 N Lake Shore Dr, Mequon, WI 53097-2418 | 2018-12-27 |
| 1497227185 | Nicole Reith | Specialist/Technologist | 12800 N Lake Shore Dr, Mequon, WI 53097-2418 | 2018-12-19 |
| 1376033126 | Samuel David Gjerset Vandehaar | Specialist/Technologist | 12800 N Lake Shore Dr, Mequon, WI 53097-2418 | 2018-05-17 |
| 1104315050 | Mitchell Edward Mleziva | Specialist/Technologist | 12800 N Lake Shore Dr, Mequon, WI 53097-2418 | 2018-05-07 |
| 1265920003 | Briana Devon Gratz | Student in an Organized Health Care Education/Training Program | 12800 N Lake Shore Dr, Mequon, WI 53097-2418 | 2018-04-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851512982 | Wendy S Balister | Dietitian, Registered | 13111 North Port Washington Rd, Mequon, WV 53097 | 2007-05-02 |
| 1902985922 | Lisa Lang | Counselor | 14135 North Cedarburg Road, Mequon, WI 53097 | 2006-11-02 |
| 1003915570 | Joan T Gnadt | Internal Medicine | 13133 N Port Washington Rd., Suite 111, Mequon, WI 53097 | 2006-09-21 |
| 1255439097 | Susan J Riegg | Pathology | 13111 N Port Washington Road, Mequon, WI 53097 | 2006-09-20 |
| 1891808887 | Gregory Eric Custer | Dentist | 13615 N Cedarburg Road, Mequon, WI 53097 | 2006-08-16 |
| 1114958600 | Richard K Karr | Orthopaedic Surgery | 13133n Port Washington Road, #216, Mequon, WI 53097 | 2006-07-05 |
| 1548204712 | Lauretta Lyon Schears | Occupational Therapist | 13111 N. Portwashington Rd, Mequon, WI 53097 | 2006-06-16 |
| 1235173337 | Sarah Marie Neman | Physical Therapy Assistant | 13111 N Prot Washington Rd., Mequon, WI 53097 | 2006-06-16 |
| 1538103643 | Elizabeth Gral Sullivan | Speech-Language Pathologist | 13111 North Port Washington Road, Mequon, WI 53097 | 2006-06-16 |
| 1952808701 | Lisa Lang LLC | Counselor | 14135 North Cedarburg Road, Mequon, WI 53097 | 2018-04-09 |
| Find all providers in zip 53097 | ||||
| Taxonomy Code | 225XH1200X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Occupational Therapist |
| Specialization | Hand |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174584478 | Milwaukee Hand Center, S.c. | Occupational Therapist | 1535 W Market St, Mequon, WI 53092-5053 | 2006-03-28 |
| 1639378433 | Cheri Cayon | Occupational Therapist | 1535 W Market St, Mequon, WI 53092-5053 | 2007-07-12 |
| 1306871520 | Randy Thomas Dahl | Occupational Therapist | 1535 W Market St, Mequon, WI 53092-5053 | 2006-07-12 |
| 1740231380 | Lou Ann Campbell-peterson | Occupational Therapist | 13111 N Port Washington Rd, Mequon, WI 53097-2416 | 2006-05-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053729095 | Ruth Chiapetta Kulbacki | Occupational Therapist | 2944 Salem Cir, Mount Pleasant, WI 53406-1828 | 2014-07-22 |
| 1134473556 | Tiffany Amber Cash | Occupational Therapist | 600 Hyland Ave., Madison, WI 53792 | 2012-11-07 |
| 1366696049 | Konzak Therapy LLC | Occupational Therapist | 333 W Walters St, Port Washington, WI 53074-1455 | 2008-11-07 |
| 1346442522 | Rhonda Elliott | Occupational Therapist | W227n16857 Tillie Lake Ct, Jackson, WI 53037-9000 | 2007-06-01 |
| 1215070909 | Sarah L Konzak | Occupational Therapist | 511 S 6th St, Cedar Grove, WI 53013-1679 | 2007-02-14 |
| 1386782134 | Michelle Beth Obbink | Occupational Therapist | 151 Lake Ct, Cedar Grove, WI 53013-1670 | 2007-02-02 |
| 1376511162 | Jamie Lois Ann Kolka I | Occupational Therapist | 3200 Westhill Dr Ste 201, Wausau, WI 54401-4707 | 2006-03-09 |
| 1700405081 | Anthony Joseph Condie | Occupational Therapist | 2323 N Casaloma Dr, Appleton, WI 54913-8284 | 2020-04-16 |
| 1700447208 | Hannah Joyce Hershberger | Occupational Therapist | 525 W River Woods Pkwy Ste 230, Glendale, WI 53212-1010 | 2019-06-25 |
| 1275191058 | Johanna Pipia | Occupational Therapist | 8901 W Lincoln Ave, West Allis, WI 53227-2409 | 2019-06-05 |
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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.