KIMBERLY JO GORDEN (NPI# 1902140882) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902140882 |
| Entity Type | Individual |
| Full Name | KIMBERLY JO GORDEN |
| Credential | PHARM.D. |
| Practice Address |
10 Tower Dr Sun Prairie WI 53590-1239 |
| Practice Telephone | 6088253690 |
| Mailing Telephone | 6088253690 |
| Enumeration Date | 2012-11-16 |
| Last Update Date | 2012-11-16 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | 16851-40 | WI | Pharmacy Service Providers |
| Street Address |
10 TOWER DR |
| City | SUN PRAIRIE |
| State | WI |
| Zip Code | 53590-1239 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013907310 | Melissa Mcgowan Terrill | Optometrist | 10 Tower Dr, Dean Medical Center, Sun Prairie, WI 53590-1239 | 2005-10-27 |
| 1760989982 | Kimberly K Ward | Nurse Practitioner | 10 Tower Dr, Sun Prairie, WI 53590-1239 | 2018-04-13 |
| 1205331303 | Laura A. Jacobson | Occupational Therapist | 10 Tower Dr, Sun Prairie, WI 53590-1239 | 2018-03-29 |
| 1194242917 | Ashley M Braithwaite | Nurse Practitioner | 10 Tower Dr, Sun Prairie, WI 53590-1239 | 2017-08-23 |
| 1609315159 | Kailene L Devries | Physician Assistant | 10 Tower Dr, Sun Prairie, WI 53590-1239 | 2017-02-16 |
| 1992250112 | Amanda E Conway | Nurse Practitioner | 10 Tower Dr, Sun Prairie, WI 53590-1239 | 2016-08-17 |
| 1134673783 | Stephanie M Johnson | Nurse Practitioner | 10 Tower Dr, Sun Prairie, WI 53590-1239 | 2016-08-12 |
| 1912361452 | Lindsey W Engel | Family Medicine | 10 Tower Dr, Sun Prairie, WI 53590-1239 | 2016-04-11 |
| 1154796357 | Eva Balfanz | Counselor | 10 Tower Dr, Sun Prairie, WI 53590-1239 | 2015-12-14 |
| 1568839181 | Jolene E Appiah | Occupational Therapist | 10 Tower Dr, Sun Prairie, WI 53590-1239 | 2015-08-31 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194280529 | Kasi Lucas Schroeder | Chiropractor | 110 N Grand Ave, Suite 4, Sun Prairie, WI 53590 | 2019-02-11 |
| 1770053712 | Jamie Engstrom | Psychologist | 3061 Pleasant St, 216, Sun Prairie, WI 53590 | 2018-12-03 |
| 1154837433 | Wisconsin Dental Health, LLC | Dentist | 390 S. Grand Ave, Suite#110, Sun Prairie, WI 53590 | 2017-12-21 |
| 1669981676 | Elizabeth M Gregg | Counselor | 1170 N Bird St, Sun Prairie, WI 53590 | 2017-09-21 |
| 1609298595 | Prairie Lakes Dental | Dentist | 2804 Prairie Lakes Drive, Sun Prairie, WI 53590 | 2014-01-10 |
| 1407297559 | Quality Medical Rides LLC | Non-emergency Medical Transport (VAN) | 2907 Vang Rd, Sun Prairie, WI 53590 | 2013-07-17 |
| 1376892851 | Costco Wholesale Corporation | Pharmacy | 2850 Hoepker Rd, Sun Prairie, WI 53590 | 2012-08-30 |
| 1043454234 | Dean Lewis Drake | Registered Nurse | 7281 County Rd V. V., Sun Prairie, WI 53590 | 2009-05-01 |
| 1679728992 | Dianne Mary Mayr | Registered Nurse | 3181 Nature Dr, Conservancy States Ln, Sun Prairie, WI 53590 | 2008-12-01 |
| 1043462021 | Crown Point Village, LLC | Assisted Living Facility | 881 Liberty Boulevard, Sun Prairie, WI 53590 | 2008-10-21 |
| Find all providers in zip 53590 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326225327 | Ann Schwartzwald | Pharmacist | 125 S Thompson Rd, O'connell Pharmacy Ltc, Sun Prairie, WI 53590-2526 | 2008-01-22 |
| 1457319345 | O Connell Pharmacy Ltd | Pharmacist | 302 S Grand Ave, Sun Prairie, WI 53590 | 2006-05-02 |
| 1851999510 | Virginia Mildred Bennett | Pharmacist | 1905 Mccoy Rd, Sun Prairie, WI 53590-2529 | 2020-10-15 |
| 1386259075 | Benjamin Leitzinger | Pharmacist | 125 S Thompson Rd, Sun Prairie, WI 53590-2526 | 2020-09-10 |
| 1538774286 | Joshua D Stine | Pharmacist | 302 S Grand Ave, Sun Prairie, WI 53590-9827 | 2020-09-10 |
| 1114531456 | Joshua Michael Besaw | Pharmacist | 640 E Main St, Sun Prairie, WI 53590-9696 | 2020-09-03 |
| 1548872682 | Benjamin Theodore Schmidt IIi | Pharmacist | 275 Davison Dr, Sun Prairie, WI 53590-2034 | 2020-08-19 |
| 1720615040 | Jenna Kunz | Pharmacist | 660 S Grand Ave, Sun Prairie, WI 53590-9832 | 2020-03-25 |
| 1831723915 | Joel Snorek | Pharmacist | 275 Davison Dr, Sun Prairie, WI 53590-2034 | 2020-02-27 |
| 1356975536 | Mary Elisabeth Johnson | Pharmacist | 546 N Grand Ave, Sun Prairie, WI 53590-9819 | 2020-02-26 |
| Find all providers in SUN PRAIRIE | ||||
| City | SUN PRAIRIE |
| Zip Code | 53590 |
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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.