ELLIOT M SIMON (NPI# 1750779856) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750779856 |
| Entity Type | Individual |
| Full Name | ELLIOT M SIMON |
| Credential | PHYSICIAN ASSISTANT |
| Practice Address |
6308 8th Ave Suite 1020 Kenosha WI 53143-5031 |
| Practice Telephone | 2626563150 |
| Practice Fax Number | 2626562634 |
| Mailing Telephone | 2626563150 |
| Mailing Fax Number | 2626562634 |
| Enumeration Date | 2014-12-26 |
| Last Update Date | 2015-02-21 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 3457-23 | WI | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
6308 8TH AVE SUITE 1020 |
| City | KENOSHA |
| State | WI |
| Zip Code | 53143-5031 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366440851 | Janet S Barney | Nurse Practitioner | 6308 8th Ave, Suite 2000, Kenosha, WI 53143-5031 | 2005-07-08 |
| 1669094165 | Simona Slavinskiene | Nurse Practitioner | 6308 8th Ave, Kenosha, WI 53143-5031 | 2020-05-07 |
| 1366063133 | Lisa Neyens | Pharmacist | 6308 8th Ave, Kenosha, WI 53143-5031 | 2020-05-02 |
| 1164056727 | Michael James Church | Physician Assistant | 6308 8th Ave, Kenosha, WI 53143-5031 | 2020-02-23 |
| 1215593009 | Ihc-wound Care Services LLC | Emergency Medicine | 6308 8th Ave, Kenosha, WI 53143-5031 | 2019-05-16 |
| 1609358357 | Samantha M Rhodes | Physical Therapist | 6308 8th Ave, Kenosha, WI 53143-5031 | 2018-08-29 |
| 1063953784 | Megan Roethle | Registered Nurse | 6308 8th Ave, Kenosha, WI 53143-5031 | 2017-03-14 |
| 1043678683 | Sarah Rens | Physician Assistant | 6308 8th Ave, Kenosha, WI 53143-5031 | 2016-02-09 |
| 1922472422 | Catherine A Hernandez | Physician Assistant | 6308 8th Ave, Kenosha, WI 53143-5031 | 2015-11-20 |
| 1366844714 | Illinois Bone and Joint Institute, LLC | Orthopaedic Surgery | 6308 8th Ave, Suite 2000, Kenosha, WI 53143-5031 | 2014-09-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891262275 | Shanda L Goecks | Registered Nurse | 6916 26th Ave, Kenosha, WI 53143 | 2018-10-24 |
| 1689942989 | Racine Kenosha Community Action Agency | Public Health or Welfare | 2000 63rd Street, Kenosha, WI 53143 | 2011-12-01 |
| 1538497797 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 7525 Sheridan Rd, Kenosha, WI 53143 | 2009-11-30 |
| 1497929012 | Ebba M Johnson | Physical Therapist | 524 74th Street, Kenosha, WI 53143 | 2008-04-15 |
| 1770789489 | Kenosha Community Health Center, Inc | Family Medicine | 6226 14th Ave, Kenosha, WI 53143 | 2007-06-21 |
| 1558413161 | Junith M Thompson | Obstetrics & Gynecology | 6530 Sheridan Road, Kenosha, WI 53143 | 2007-01-17 |
| 1154471332 | Ljh Ambulance, Inc | Ambulance | 6329 28th Ave, Kenosha, WI 53143 | 2007-01-11 |
| 1578625794 | Michael A Schellpfeffer Md Ob Gyn Sc | Obstetrics & Gynecology | 1400 75th Street, Kenosha, WI 53143 | 2006-12-14 |
| 1457468654 | Yasmine S Sido | Physician Assistant | 7550 22nd Ave, Kenosha, WI 53143 | 2006-08-24 |
| 1356307359 | Nancy Jane Houtchens | Dentist | 7533 22nd Ave, Ste 100, Kenosha, WI 53143 | 2006-04-26 |
| Find all providers in zip 53143 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043843592 | Brian Owings | Physician Assistant | 3400 Market Ln # 300, Kenosha, WI 53144-3430 | 2020-02-12 |
| 1225409485 | Antonia Marie Decker | Physician Assistant | 10400 75th St. Ste 204, Kenosha, WI 53142 | 2015-10-14 |
| 1215311881 | Sarah Ann Moony | Physician Assistant | 8500 75th St Ste 102, Kenosha, WI 53142-8213 | 2015-07-14 |
| 1194097311 | Emily Ann Lee | Physician Assistant | 10400 75th St Ste 215, Kenosha, WI 53142-7884 | 2012-02-03 |
| 1629364815 | Alyssa M Ricchio | Physician Assistant | 10400 75th St Ste 700, Kenosha, WI 53142-7884 | 2011-06-26 |
| 1649506874 | Briana Elizabeth Aiken | Physician Assistant | 2801 14th Pl, Kenosha, WI 53140-4300 | 2009-10-22 |
| 1144317736 | Sarah N Stachon | Physician Assistant | 8959 34th Ave, Kenosha, WI 53142-5412 | 2006-10-06 |
| 1457468654 | Yasmine S Sido | Physician Assistant | 7550 22nd Ave, Kenosha, WI 53143 | 2006-08-24 |
| 1154377091 | Keven R Mottinger | Physician Assistant | 3400 Market Ln, Kenosha, WI 53144-3430 | 2006-05-25 |
| 1164056727 | Michael James Church | Physician Assistant | 6308 8th Ave, Kenosha, WI 53143-5031 | 2020-02-23 |
| Find all providers in KENOSHA | ||||
Please comment or provide details below to improve the information on ELLIOT M SIMON.
| 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.