CSM COMMUNITY PHYSICIAN (NPI# 1801100243) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801100243 |
| Entity Type | Organization |
| Organization Name | CSM COMMUNITY PHYSICIAN |
| Other Organization Name | CSMCP CARDIAC RHYTHM SPECIALIST |
| Practice Address |
2350 N Lake Dr Suite 206 Milwaukee WI 53211-4528 |
| Mailing Address |
Po Box 78309 Milwaukee WI 53278-0001 |
| Practice Telephone | 4142987280 |
| Practice Fax Number | 4142987281 |
| Mailing Telephone | 4142987280 |
| Mailing Fax Number | 4142987281 |
| Enumeration Date | 2010-07-27 |
| Last Update Date | 2010-11-24 |
| Authorized Official Name | MS. DEBORAH E BJORN (PRACTICE ADMINISTRATOR) |
| Authorized Official Telephone | 4142987284 |
| Is Organization Subpart | Y |
| Parent Organization Name | COLUMBIA ST MARYS HOSPITAL MILWAUKEE INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM2500X |
Clinic/Center Specialization: Medical Specialty |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 32793800 | 05 |
| Other Name | Type Code |
|---|---|
| CSMCP Cardiac Rhythm Specialist | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518271956 | Csm Community Physician | Clinic/Center | 13133 N Port Washington Rd, Suite 122, Mequon, WI 53097-2419 | 2010-07-27 |
| 1366773780 | Csm Community Physician | Internal Medicine | 2700 W 9th Ave, Suite 106, Oshkosh, WI 54904-7247 | 2010-01-25 |
| Street Address |
2350 N LAKE DR SUITE 206 |
| City | MILWAUKEE |
| State | WI |
| Zip Code | 53211-4528 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194721407 | Nguyen H Phan | Internal Medicine | 2350 N Lake Dr, Ste 206, Milwaukee, WI 53211-4528 | 2005-06-22 |
| 1326650698 | Dylan Henry Menefee | Physician Assistant | 2350 N Lake Dr, Milwaukee, WI 53211-4528 | 2020-08-18 |
| 1659936169 | Cadie Leigh Roszak | Nurse Practitioner | 2350 N Lake Dr, Milwaukee, WI 53211-4528 | 2019-05-09 |
| 1457884165 | Shelly A. Boyd | Nurse Practitioner | 2350 N Lake Dr, Suite 302, Milwaukee, WI 53211-4528 | 2017-04-10 |
| 1043663818 | Kelly Brock | Physician Assistant | 2350 N Lake Dr, Suite 206, Milwaukee, WI 53211-4528 | 2016-07-18 |
| 1376996397 | Jennifer Gallagher | Physician Assistant | 2350 N Lake Dr, Suite 206, Milwaukee, WI 53211-4528 | 2016-07-14 |
| 1104285873 | Catherine Bares | Nurse Practitioner | 2350 N Lake Dr, Suite 100, Milwaukee, WI 53211-4528 | 2016-02-23 |
| 1578921375 | Heather Bastjan | Nurse Practitioner | 2350 N Lake Dr, Suite 500, Milwaukee, WI 53211-4528 | 2016-02-08 |
| 1033586292 | Angela Kraus | Nurse Practitioner | 2350 N Lake Dr, Suite 302, Milwaukee, WI 53211-4528 | 2015-08-24 |
| 1871974964 | Tatyana Trendafilova Radulovic | Nurse Practitioner | 2350 N Lake Dr, Suite 302, Milwaukee, WI 53211-4528 | 2015-06-15 |
| Find all providers in the same location | ||||
| 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 |
| Find all providers in zip 53211 | ||||
| Taxonomy Code | 261QM2500X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Medical Specialty |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer). |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104222330 | Premier Cardiovascular Institute of Wisconsin LLC | Clinic/Center | 1309 S 54th St, Milwaukee, WI 53214-3404 | 2014-11-17 |
| 1265544498 | Affiliated Ent, Sc | Clinic/Center | 2500 N Mayfair Rd Ste 450, Milwaukee, WI 53226-1443 | 2006-09-01 |
| 1669911277 | Garland W. Yarborough M.d S,c | Clinic/Center | 2500 W Layton Ave, Suite250, Milwaukee, WI 53221-5420 | 2017-02-15 |
| 1184805848 | Alliance Ent and Hearing Center, Sc | Clinic/Center | 201 N Mayfair Rd, Suite 515, Milwaukee, WI 53226-4216 | 2007-11-21 |
| 1538368949 | Farzad Kamrani,md.sc. | Clinic/Center | 3201 S 16th St, S# 2007, Milwaukee, WI 53215-4537 | 2007-07-16 |
| 1992713531 | Children's Hospital and Health System, Inc. | Clinic/Center | 9000 W Wisconsin Ave, Milwaukee, WI 53226-3518 | 2006-08-03 |
| 1811992233 | Blount Orthopaedic Clinic Ltd | Clinic/Center | 625 E Saint Paul Ave, Milwaukee, WI 53202-5907 | 2005-06-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518446558 | Northwoods Family Physical Medicine of Wisconsin, S.c. | Clinic/Center | 2360a Duck Creek Pkwy Ste 2, Green Bay, WI 54303-3377 | 2018-08-10 |
| 1629498522 | Asana Health & Wellness LLC | Clinic/Center | 2372 S Oneida St, Green Bay, WI 54304-5256 | 2014-04-18 |
| 1467792457 | Vein Care Associates S.c. | Clinic/Center | 215 Corporate Drive, Suite H, Beaver Dam, WI 53916-3124 | 2013-02-27 |
| 1447532403 | Lavender Lotus Acupuncture LLC | Clinic/Center | 130 Gregor St, Waterloo, WI 53594-1224 | 2011-09-15 |
| 1043501356 | Steven Victor Bittorf | Clinic/Center | 2505 Parkwood Dr, Green Bay, WI 54304-1956 | 2011-04-21 |
| 1881927812 | Gail A Weinand | Clinic/Center | 203 Schiek Plz, Rhinelander, WI 54501-3364 | 2009-09-09 |
| 1932368685 | Center for Stomach & Intestinal Disorders Ltd | Clinic/Center | 2300 N Mayfair Rd Ste 725, Wauwatosa, WI 53226-1533 | 2008-06-07 |
| 1568641439 | Daniel L. Gauerkei Dba Broadway Vision Center | Clinic/Center | 815 W Fulton St, Suite 103, Waupaca, WI 54981-1405 | 2007-10-29 |
| 1174723084 | Bruns Chiropractic Office Sc | Clinic/Center | 1429 North Ave, Sheboygan, WI 53083-4760 | 2007-07-19 |
| 1891919411 | Raether Chiropractic Office, S.c. | Clinic/Center | 511 E Rhine St, Elkhart Lake, WI 53020-0673 | 2007-04-13 |
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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.