BRYAN KOUDIM (NPI# 1821540618) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821540618 |
| Entity Type | Individual |
| Full Name | BRYAN KOUDIM |
| Credential | PTA |
| Practice Address |
9047 W Greenfield Ave Milwaukee WI 53214-2808 |
| Mailing Address |
S78w18465 Lions Park Dr Muskego WI 53150-8704 |
| Practice Telephone | 4144539290 |
| Mailing Telephone | 2623091253 |
| Enumeration Date | 2016-10-27 |
| Last Update Date | 2016-10-27 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 246Z00000X | Specialist/Technologist, Other | 254819 | WI | Technologists, Technicians & Other Technical Service Providers |
| Street Address |
9047 W GREENFIELD AVE |
| City | MILWAUKEE |
| State | WI |
| Zip Code | 53214-2808 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275192676 | Alexandria Mia Hagen | Student in an Organized Health Care Education/Training Program | 9047 W Greenfield Ave, Milwaukee, WI 53214-2800 | 2019-06-10 |
| 1285118448 | Madison Meier | Speech-Language Pathologist | 9047 W Greenfield Ave, Milwaukee, WI 53214-2800 | 2018-09-23 |
| 1609375203 | Emily Lindeman | Speech-Language Pathologist | 9047 W Greenfield Ave, Milwaukee, WI 53214-2808 | 2018-02-08 |
| 1457803850 | Joseph Michael Lidester | Physical Therapy Assistant | 9047 W Greenfield Ave, Milwaukee, WI 53214-2808 | 2016-11-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740740208 | Melanie Figueroa | Counselor | West Milwaukee Ctc, 1610 Miller Park Way, West Milwaukee, WI 53214 | 2019-03-21 |
| 1619403011 | Lea Salome Denny | Counselor | 8626b W Greenfield Ave, Suite B300, West Allis, WI 53214 | 2017-05-04 |
| 1891148318 | West Allis Prescription Center Inc | Pharmacy | 6737 W Washington Ave, Suite 1100, West Allis, WI 53214 | 2016-07-20 |
| 1316390495 | Kristina Overlee | Nurse Practitioner | 6737 W. Washington Street, Suite 2150, West Allis, WI 53214 | 2016-07-13 |
| 1801239843 | Daniel Anthony Cichy | Pharmacist | 10101 W Greenfield Ave Ste 130, West Allis, WI 53214 | 2013-04-09 |
| 1295072544 | Wisconsin Vision, Inc. | Optometrist | 1220 Miller Park Way, West Milwaukee, WI 53214 | 2013-01-07 |
| 1831457720 | Kevin Konieczka | Physical Therapist | 1224 Miller Parkway, Milwaukee, WI 53214 | 2012-04-27 |
| 1497031843 | Jill Elizabeth Gerou | Registered Nurse | 8420 West Greenfield Ave, Apartment #7, West Allis, WI 53214 | 2011-10-31 |
| 1700176815 | Carolyn Hasek | Counselor | 1126 S 70th St Ste 112-113, West Allis, WI 53214 | 2011-04-10 |
| 1972802775 | Barbara Smith | Licensed Practical Nurse | 651 S 63 St, Apt1, Milwaukee, WI 53214 | 2011-03-18 |
| Find all providers in zip 53214 | ||||
| Taxonomy Code | 246Z00000X |
| Grouping | Technologists, Technicians & Other Technical Service Providers |
| Classification | Specialist/Technologist, Other |
| General classification identifying individuals trained on specific equipment and technical procedures in one of a collection of miscellaneous healthcare disciplines. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801081393 | Bryant Cannon | Specialist/Technologist, Other | 544 E Ogden Ave, 700-265, Milwaukee, WI 53202-2698 | 2007-09-08 |
| 1366790867 | Tanya Lynne Watson | Specialist/Technologist, Other | 620 S 76th St, Milwaukee, WI 53214-1599 | 2012-08-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780931725 | Angelina Marie Lettiere | Specialist/Technologist, Other | 3508 Stewart Ave, Wausau, WI 54401-4919 | 2012-08-09 |
| 1710244876 | Robert Pamenter | Specialist/Technologist, Other | 3424 Superior Ave, Sheboygan, WI 53081-1862 | 2012-04-13 |
| 1073795506 | Kristine J. Clark | Specialist/Technologist, Other | Valley Orthopedic Clinic Sc, 2105 E Enterprise Ave., Ste 111, Appleton, WI 54913-7862 | 2007-11-27 |
| 1386775906 | Barbara Marie Van Lieshout | Specialist/Technologist, Other | 229 Meadow Ct, Jefferson, WI 53549-1184 | 2007-03-07 |
| 1770611741 | Steven Weber | Specialist/Technologist, Other | 305 Karen Ct, Madison, WI 53705-5026 | 2007-03-01 |
| 1962419457 | Diana Mccarthy | Specialist/Technologist, Other | 714 Oregon St, Oshkosh, WI 54902-5968 | 2006-08-01 |
| 1073528493 | Ashley Marie Rockey | Specialist/Technologist, Other | 2105 E Enterprise Ave Ste 111, Appleton, WI 54913-7862 | 2006-07-31 |
| 1407337991 | Debora Armstrong | Specialist/Technologist, Other | 2001 W Broadway, Monona, WI 53713-3707 | 2018-08-23 |
| 1205372323 | Sadie Olson | Specialist/Technologist, Other | 800 Compassion Way, Dodgeville, WI 53533-1956 | 2017-01-12 |
| 1710323563 | Physically Correct Physical Therapy Services, LLC | Specialist/Technologist, Other | 5889 Riverside Dr, Greendale, WI 53129-2817 | 2013-05-21 |
| Find all providers with the same taxonomy | ||||
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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.