DR. KENNETH RUSSELL WALLER III (NPI# 1841546959) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1841546959 |
| Entity Type | Individual |
| Full Name | DR. KENNETH RUSSELL WALLER III |
| Credential | DVM, MS |
| Practice Address |
2015 Linden Dr Room 2058 Madison WI 53706-1100 |
| Practice Telephone | 6082637656 |
| Mailing Telephone | 6082637656 |
| Enumeration Date | 2012-07-25 |
| Last Update Date | 2012-07-25 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 174M00000X | Veterinarian | 090010797 | IL | Other Service Providers |
| N | 174M00000X | Veterinarian | 7379 | IA | Other Service Providers |
| Y | 174M00000X | Veterinarian | 6054 | WI | Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518921238 | Kenneth William Waller | Physical Medicine & Rehabilitation | 100 Emancipation Dr, Hampton, VA 23667-0001 | 2006-04-12 |
| Street Address |
2015 LINDEN DR ROOM 2058 |
| City | MADISON |
| State | WI |
| Zip Code | 53706-1100 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073765202 | Kathern Elizabeth Myrna | Veterinarian | 2015 Linden Dr, Svm Dept Surgical Sciences- Ophthalmology, Madison, WI 53706-1100 | 2008-10-21 |
| 1861831679 | Constance Fazio | Veterinarian | 2015 Linden Dr, Uw Veterinary Care, Madison, WI 53706-1100 | 2013-06-14 |
| 1376778829 | Uw-madison Vet Med Hospital Pharmacy | Pharmacy | 2015 Linden Dr, Uw Madison School of Veterinary Medicine Pharmacy, Madison, WI 53706-1100 | 2009-05-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639297344 | Takuya Minami | Psychologist | 305 Education Building, 1000 Bascom Mall, Counseling Psychology, University of Wisconsin-madison, Madison, WI 53706 | 2007-03-27 |
| 1922071083 | Jon C Douglas | Audiologist | 1975 Willow Dr, University of Wisconsin Speech and Hearing Clinic, Madison, WI 53706-1103 | 2006-02-09 |
| 1578730487 | Kimberly Marie Smuda | Audiologist | 1975 Willow Dr, Madison, WI 53706-1103 | 2008-05-09 |
| 1366618787 | Jamie Elizabeth Murray-branch | Speech-Language Pathologist | 1975 Willow Dr, Madison, WI 53706-1103 | 2008-05-06 |
| 1548433956 | Patricia B Schraeder | Speech-Language Pathologist | 1975 Willow Dr, Uw Madison Departmen, Madison, WI 53706-1103 | 2008-04-07 |
| 1073783692 | University Speech and Hearing Clinic | Clinic/Center | 1975 Willow Dr, Madison, WI 53706-1103 | 2008-03-11 |
| 1215037213 | Daniel T Stoppenbach | Audiologist | 1975 Willow Dr, Madison, WI 53706-1103 | 2006-09-22 |
| 1710518113 | Alyssa Volz | Student in an Organized Health Care Education/Training Program | 2000 Observatory Dr # 1037, Madison, WI 53706-1121 | 2020-02-04 |
| 1093346488 | Grace Kunesh | Student in an Organized Health Care Education/Training Program | 2000 Observatory Dr # 1057, Madison, WI 53706-1121 | 2020-02-04 |
| 1801096391 | Andrew Patrick Winterstein | Specialist/Technologist | 2000 Observatory Dr, Madison, WI 53706-1121 | 2007-07-23 |
| Find all providers in zip 53706 | ||||
| Taxonomy Code | 174M00000X |
| Grouping | Other Service Providers |
| Classification | Veterinarian |
| A doctor of veterinary medicine, trained and authorized to practice veterinarian medicine and surgery. |
| Notes: Source: Dorland’s Illustrated Medical Dictionary. 28th edition. Philadelphia: W.B. Saunders Company, 1994, p. 1823 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700252582 | Ruth Schmidtchen | Veterinarian | 709 W 2nd St, Madison, IN 47250-3141 | 2015-08-17 |
| 1548696578 | Kathryn E Kuehl | Veterinarian | 5132 Voges Rd, Madison, WI 53718-6941 | 2013-09-23 |
| 1073765202 | Kathern Elizabeth Myrna | Veterinarian | 2015 Linden Dr, Svm Dept Surgical Sciences- Ophthalmology, Madison, WI 53706-1100 | 2008-10-21 |
| 1669633988 | Bruce Jens | Veterinarian | 1848 Waldorf Blvd, Madison, WI 53719-4562 | 2008-06-19 |
| 1063849362 | Rebecca Stuntebeck | Veterinarian | 5132 Voges Rd, Madison, WI 53718-6941 | 2013-10-01 |
| 1861831679 | Constance Fazio | Veterinarian | 2015 Linden Dr, Uw Veterinary Care, Madison, WI 53706-1100 | 2013-06-14 |
| 1669759122 | Robert Racelis | Veterinarian | 34 Hughes Rd, Ste E, Madison, AL 35758-3000 | 2011-11-12 |
| 1699907063 | Julia Ann Bates | Veterinarian | 1848 Waldorf Blvd, Madison, WI 53719-4562 | 2009-08-18 |
| 1700032588 | Michelle Lee Annese | Veterinarian | 262 Main St, Madison, NJ 07940-2210 | 2008-08-13 |
| 1598932238 | Wende Jeanne Saunders | Veterinarian | 262 Main St, Madison, NJ 07940-2210 | 2008-05-12 |
| Find all providers in MADISON | ||||
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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.