DR. PATRICK J MCKENZIE (NPI# 1881620565) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1881620565 |
| Entity Type | Individual |
| Full Name | DR. PATRICK J MCKENZIE |
| Credential | MD |
| Practice Address |
1630 Commanche Ave Green Bay WI 54313-5753 |
| Mailing Address |
Po Box 22487 Green Bay WI 54305-2487 |
| Practice Telephone | 9205935555 |
| Practice Fax Number | 9204457289 |
| Mailing Telephone | 9204457226 |
| Mailing Fax Number | 9204457289 |
| Enumeration Date | 2006-06-24 |
| Last Update Date | 2016-01-19 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207XX0005X |
Orthopaedic Surgery Specialization: Sports Medicine |
25996-20 | WI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 31480700 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801975388 | Patrick A Mckenzie | Physical Therapist | 610 Gordon St, Harrington, DE 19952-1217 | 2006-11-03 |
| 1699112086 | Patrick Carroll Mckenzie | Internal Medicine | 50 N Medical Dr, Salt Lake City, UT 84132-1622 | 2013-05-27 |
| 1225359920 | Patrick Lee Mckenzie | Urology | 509 N Elam Ave Fl 2, Greensboro, NC 27403-1157 | 2010-06-16 |
| 1699098749 | Patrick Douglas Mckenzie | Nurse Practitioner | 4700 Northgate Blvd, Suite 100, Sacramento, CA 95834-1128 | 2010-03-03 |
| 1740325687 | Patrick Lindquist Mckenzie | Dentist | 1900 South Puget Drive, Suite 102, Rentori, WA 98055-4404 | 2007-02-20 |
| Street Address |
1630 COMMANCHE AVE |
| City | GREEN BAY |
| State | WI |
| Zip Code | 54313-5753 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568456598 | Mark Thomas Husen | Specialist/Technologist | 1630 Commanche Ave, Green Bay, WI 54313-5753 | 2005-09-06 |
| 1730790577 | Haley A Steffanus | Occupational Therapist | 1630 Commanche Ave, Green Bay, WI 54313-5753 | 2020-08-14 |
| 1669097788 | Ashley Nicole Hopp | Counselor | 1630 Commanche Ave, Green Bay, WI 54313-5753 | 2020-06-15 |
| 1992339865 | Thomas D Nachtwey | Occupational Therapist | 1630 Commanche Ave, Green Bay, WI 54313-5753 | 2020-02-28 |
| 1922562164 | Cori M Thayse | Registered Nurse | 1630 Commanche Ave, Green Bay, WI 54313-5753 | 2019-01-22 |
| 1558843128 | Andrew D Kausak | Physical Therapist | 1630 Commanche Ave, Green Bay, WI 54313-5753 | 2018-08-30 |
| 1326559592 | Baycare Clinic, LLP | Neurological Surgery | 1630 Commanche Ave, Green Bay, WI 54313-5753 | 2017-10-16 |
| 1942728001 | Katie L Boehm | Physical Therapist | 1630 Commanche Ave, Green Bay, WI 54313-5753 | 2017-09-08 |
| 1205350865 | Jacob R Birdsall | Physical Therapist | 1630 Commanche Ave, Green Bay, WI 54313-5753 | 2017-07-26 |
| 1922528801 | Jacob Paul Meyer | Family Medicine | 1630 Commanche Ave, Green Bay, WI 54313-5753 | 2017-06-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548823420 | Martha Lynn Drew | Licensed Practical Nurse | 3101 Molly Brown Lane, Green Day, WI 54313 | 2019-04-17 |
| 1831691872 | Melanie Hammerbeck | Dentist | 1756 Cardinal Ln, Green Bay, WI 54313 | 2018-03-06 |
| 1649727108 | Amanda Marie Mckeefry | Dental Hygienist | 2304 Lineville Rd, Suite 101, Green Bay, WI 54313 | 2016-09-01 |
| 1326594813 | Kaylee Schartner | Dental Hygienist | 2304 Lineville Road, Suite 100, Suamico, WI 54313 | 2016-08-25 |
| 1134500226 | Salvanz Enterprises Inc | Pharmacy | 2673 Lineville Road, Green Bay, WI 54313 | 2015-06-15 |
| 1467849307 | Maureen Riordan | Specialist/Technologist | 2957 S Telemark Cir., Green Bay, WI 54313 | 2015-04-17 |
| 1043556780 | Kellen James Binder | Chiropractor | 2638 Tulip Lane, Suite B, Green Bay, WI 54313 | 2012-12-28 |
| 1407092737 | Sara Ann Anderson | Registered Nurse | 2691 Shade Tree Ln, Green Bay, WI 54313 | 2008-12-16 |
| 1467601344 | Melissa Lea Socha | Speech-Language Pathologist | 2153 School Lane, Suamiro Elementary, Green Bay, WI 54313 | 2008-09-16 |
| 1003070707 | Anne Marie Hein | Physical Therapist | 3101 S Packerland Dr, Green Bay, WI 54313 | 2008-07-11 |
| Find all providers in zip 54313 | ||||
| Taxonomy Code | 207XX0005X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| Specialization | Sports Medicine |
| An orthopaedic surgeon trained in sports medicine provides appropriate care for all structures of the musculoskeletal system directly affected by participation in sporting activity. This specialist is proficient in areas including conditioning, training and fitness, athletic performance and the impact of dietary supplements, pharmaceuticals, and nutrition on performance and health, coordination of care within the team setting utilizing other health care professionals, field evaluation and management, soft tissue biomechanics and injury healing and repair. Knowledge and understanding of the principles and techniques of rehabilitation, athletic equipment and orthotic devices enables the specialist to prevent and manage athletic injuries. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton changed, source changed] Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. ACGME Accredited Program Requirements: 1 year GME in the specialty + 5 years of Orthopaedic Surgery for a total of 6 years |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992953921 | William David Jones | Orthopaedic Surgery | 1554 River Pines Dr, Green Bay, WI 54311-5648 | 2008-09-03 |
| 1649392549 | Padraic Rory Obma | Orthopaedic Surgery | 1726 Shawano Ave, Green Bay, WI 54303-3216 | 2007-04-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144464199 | Lyall Carlton Stilp II | Orthopaedic Surgery | 2133 Willow Ln, Oshkosh, WI 54902-9121 | 2009-04-21 |
| 1588639256 | Albert J Cecchini | Orthopaedic Surgery | 3119 Woodman Dr, Altoona, WI 54720-2668 | 2006-02-17 |
| 1811992886 | Tamara A Scerpella | Orthopaedic Surgery | 621 Science Dr, Madison, WI 53711-1074 | 2005-06-16 |
| 1538716725 | Jessica Lynn Flood | Orthopaedic Surgery | 4602 Eastpark Blvd, Madison, WI 53718-2002 | 2019-08-22 |
| 1154883593 | Kristin K. Lietzau | Orthopaedic Surgery | Beloit Clinic, 1905 E. Huebbe Parkway, Beloit, WI 53511-1842 | 2019-04-04 |
| 1154839140 | Sandra Koester | Orthopaedic Surgery | 1111 Delafield St, Waukesha, WI 53188 | 2018-01-12 |
| 1750736120 | Orthopaedic Centers of Wisconsin, S.c. | Orthopaedic Surgery | 500 Vincent St, Stevens Point, WI 54481-1842 | 2016-05-04 |
| 1740549773 | Community Health Network Inc | Orthopaedic Surgery | 191 Memorial Dr, Berlin, WI 54923-1241 | 2012-05-11 |
| 1922322429 | Andrea M. Spiker | Orthopaedic Surgery | 4602 Eastpark Blvd, Madison, WI 53718-2002 | 2010-03-26 |
| 1871753517 | Brian Foley Grogan | Orthopaedic Surgery | 4602 Eastpark Blvd, Madison, WI 53718-2002 | 2008-06-16 |
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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.