WEST BEND CLINIC (NPI# 1881749919) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1881749919 |
| Entity Type | Organization |
| Organization Name | WEST BEND CLINIC |
| Other Organization Name | WEST BEND CLINIC OPTICAL |
| Practice Address |
1700 W Paradise Dr West Bend WI 53095-9795 |
| Practice Telephone | 2623343451 |
| Enumeration Date | 2007-01-25 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | JAMES N BROWNE (ADMINISTRATOR) |
| Authorized Official Telephone | 2623343451 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332H00000X | Eyewear Supplier (Equipment, not the service) | Suppliers |
| Other Name | Type Code |
|---|---|
| West Bend Clinic Optical | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518976919 | West Bend Clinic | Internal Medicine | 1701 Fond Du Lac Ave, Kewaskum, WI 53040-9129 | 2006-08-05 |
| 1275542607 | West Bend Clinic | Durable Medical Equipment & Medical Supplies | W225n16711 Cedar Park Ct, Jackson, WI 53037-9222 | 2006-08-05 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | WEST BEND CLINIC, LLC | 760 Nw York Dr, Bend, OR 97703 |
| Street Address |
1700 W PARADISE DR |
| City | WEST BEND |
| State | WI |
| Zip Code | 53095-9795 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811980568 | Mark R Meuler | Optometrist | 1700 W Paradise Dr, West Bend, WI 53095-9795 | 2005-08-29 |
| 1902405186 | Ashley Renee Miller | Physical Therapist | 1700 W Paradise Dr, West Bend, WI 53095-9795 | 2020-10-20 |
| 1114552312 | Emily Hope Gorman | Registered Nurse | 1700 W Paradise Dr, West Bend, WI 53095-9795 | 2020-03-08 |
| 1992354823 | Froedtert Health Pharmacy LLC | Pharmacy | 1700 W Paradise Dr, West Bend, WI 53095-9795 | 2019-09-04 |
| 1184180994 | Jennifer Jean Schmidt | Nurse Practitioner | 1700 W Paradise Dr, West Bend, WI 53095-9795 | 2019-02-17 |
| 1770055782 | Lori Jo Dauss | Specialist/Technologist | 1700 W Paradise Dr, West Bend, WI 53095-9795 | 2019-01-02 |
| 1851808059 | Allison Danielle Kaczmarek | Nurse Practitioner | 1700 W Paradise Dr, West Bend, WI 53095-9795 | 2018-01-09 |
| 1306360409 | Jeremiah Christian Parve | Nurse Practitioner | 1700 W Paradise Dr, West Bend, WI 53095-9795 | 2017-07-31 |
| 1124540372 | Leslie Ann Weiss Russo | Physician Assistant | 1700 W Paradise Dr, West Bend, WI 53095-9795 | 2017-07-10 |
| 1134656374 | Daniela Aleman | Family Medicine | 1700 W Paradise Dr, West Bend, WI 53095-9795 | 2017-05-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942820428 | David Fountain | Contractor | 726 Creedwood Lane, West Bend, WI 53095 | 2020-04-24 |
| 1922664358 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 1745 South Main St, West Bend, WI 53095 | 2019-05-10 |
| 1912423773 | Michelle R Prentice | Family Medicine | West Bend Health Center, 1700 W. Paradise Drive, West Bend, WI 53095 | 2017-08-14 |
| 1386165918 | Quad/med, LLC | Clinic/Center | 432 E. Washington St. #1115, West Bend, WI 53095 | 2017-07-05 |
| 1508230632 | Jesen Daniel | Counselor | 111 East Washington St, Affiliated Clinical Services, West Bend, WI 53095 | 2015-12-01 |
| 1477965259 | Jenna Crofts | Specialist/Technologist | 1190 East Paradise Drive, West Bend, WI 53095 | 2014-05-28 |
| 1023436342 | Visionworks | Optometrist | 1437 S. Main St., West Bend, WI 53095 | 2014-04-03 |
| 1295157295 | Stephanie Rabe | Registered Nurse | 910 E. Paradise Drive, West Bend, WI 53095 | 2014-01-09 |
| 1477898815 | Ralph Norman Olsen | Pediatrics | 6267 Riesch Road, West Bend, WI 53095 | 2012-12-11 |
| 1932458536 | Joshua Aaron Barta | Dentist | 2090 Continental Drive, West Bend, WI 53095 | 2012-08-29 |
| Find all providers in zip 53095 | ||||
| Taxonomy Code | 332H00000X |
| Grouping | Suppliers |
| Classification | Eyewear Supplier (Equipment, not the service) |
| An organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922664358 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 1745 South Main St, West Bend, WI 53095 | 2019-05-10 |
| 1609957620 | Stein Optical Inc | Eyewear Supplier (Equipment, not the service) | 1437 S. Main Street, West Bend, WI 53095 | 2006-10-17 |
| 1326090341 | Shopko Stores Operating Co. LLC | Eyewear Supplier (Equipment, not the service) | 1710 S Main St, West Bend, WI 53095-4938 | 2006-05-17 |
| 1730466277 | Visionworks, Inc. | Eyewear Supplier (Equipment, not the service) | 1437 S Main St, West Bend, WI 53095-4931 | 2011-11-11 |
| 1710289608 | Earl W Nepple M.d. | Eyewear Supplier (Equipment, not the service) | 1201 Oak St, West Bend, WI 53095-3800 | 2010-11-26 |
| 1285654012 | Aurora Health Care Ventures, Inc. | Eyewear Supplier (Equipment, not the service) | 205 Valley Ave, West Bend, WI 53095-5312 | 2006-07-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427658772 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 1073 E Johnson St, Fond Du Lac, WI 54935-8919 | 2020-10-27 |
| 1578170247 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 120 N Grand Ave Ste 102, Sun Prairie, WI 53590-9007 | 2020-09-28 |
| 1639784622 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 2268 W Mason St, Green Bay, WI 54303-4707 | 2020-09-15 |
| 1427669746 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 1607 Losey Blvd S, La Crosse, WI 54601-6151 | 2020-08-11 |
| 1710598032 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 631 Hometown Cir Ste 106, Verona, WI 53593-1561 | 2020-08-11 |
| 1871138073 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 723 Main Ave, Depere, WI 54115 | 2019-11-12 |
| 1558903815 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 422 Gammon Pl, Madison, WI 53719-1026 | 2019-10-08 |
| 1669013256 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 123 N Mall Dr, Grand Chute, WI 54913-8531 | 2019-10-04 |
| 1952962763 | Martell Eyecare, LLC | Eyewear Supplier (Equipment, not the service) | 703 Third Street, Marathon, WI 54448 | 2019-06-23 |
| 1932767316 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 1440 Capital Drive, Suite B, Pewaukee, WI 53072 | 2019-05-31 |
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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.