MITCHELL LOUIS JUDGE LI


Address: 420 E Division St, Fond Du Lac, WI 54935-4560
Phone: 9209264600

MITCHELL LOUIS JUDGE LI (NPI# 1932442464) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1932442464
Entity Type Individual
Full Name MITCHELL LOUIS JUDGE LI
Credential MD
Practice Address 420 E Division St
Fond Du Lac
WI 54935-4560
Practice Telephone 9209264600
Practice Fax Number 9209264869
Mailing Telephone 9209264600
Mailing Fax Number 9209264869
Enumeration Date 2013-04-03
Last Update Date 2019-06-27
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 207P00000X Emergency Medicine 4301106252 MI Allopathic & Osteopathic Physicians
Y 207PE0004X Emergency Medicine
Specialization: Emergency Medical Services
65823-20 WI Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
MI MI LIMITED LICENSE NUMBER 4301106252 01

Provider Secondary Practice Location

Address Telephone Number Fax Number
2661 County Highway I, Chippewa Falls, WI 547295407 7157231811
900 W Clairemont Ave, Eau Claire, WI 547016122 7157144121

Other Providers MITCHELL LI

NPI Name Taxonomy Address Enumeration
1992326771 Mitchell C Li Nurse Practitioner 177 Fort Washington Ave, New York, NY 10032-3733 2020-05-02

Office Location

Street Address 420 E DIVISION ST
City FOND DU LAC
State WI
Zip Code 54935-4560

Providers in the same location

NPI Name Taxonomy Address Enumeration
1760489017 Ronald Eric Lilly Thoracic Surgery (Cardiothoracic Vascular Surgery) 420 E Division St, Fond Du Lac, WI 54935-4560 2005-07-01
1831715721 Agnesian Healthcare Inc Preventive Medicine 420 E Division St, Fond Du Lac, WI 54935-4560 2020-06-17
1336783042 Lisa Jo Liedke Nurse Practitioner 420 E Division St, Fond Du Lac, WI 54935-4560 2019-11-05
1932740495 Terrina Kay Goeden Nurse Practitioner 420 E Division St, Fond Du Lac, WI 54935-4560 2019-10-04
1801441910 Courtney M Yenter Nurse Practitioner 420 E Division St, Fond Du Lac, WI 54935-4560 2019-08-06
1861046591 Kimberly Kay Hornes Nurse Practitioner 420 E Division St, Fond Du Lac, WI 54935-4560 2019-07-31
1023662459 Domenick Tirabassi Iv Student in an Organized Health Care Education/Training Program 420 E Division St, Fond Du Lac, WI 54935-4560 2019-07-24
1497308233 Kelly Jo Rehfeldt Nurse Practitioner 420 E Division St, Fond Du Lac, WI 54935-4560 2019-07-22
1184286411 Carley Jo Reinke Nurse Practitioner 420 E Division St, Fond Du Lac, WI 54935-4560 2019-07-08
1255823316 Teegan R Kraus Physician Assistant 420 E Division St, Fond Du Lac, WI 54935 2018-06-05
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1609482249 Keziah Sherri Love Counselor W390 Wi-23, Fond Du Lac, WI 54935 2020-09-18
1891341988 Cynthia Louise Singleton Nurse Practitioner 16 E 13th St., Fond Du Lac, WI 54935 2019-08-14
1083183297 Elena Alexandra Giese Nurse Practitioner 430 E. Division St, Fond Du Lac, WI 54935 2018-11-16
1669963740 Elizabeth Anne Machi Student in an Organized Health Care Education/Training Program 885 Western Ave Ste 300, Fond Du Lac, WI 54935 2018-05-23
1184150021 Jordan Moehn Specialist/Technologist 633 Prairie Pkwy, Fond Du Lac, WI 54935 2017-05-11
1467856336 Chuentao Ho Specialist/Technologist 45 South National Ave., Fond Du Lac, WI 54935 2014-10-21
1437587961 Paula Seeley Nurse Practitioner 63 West Pioneer Rd, Fond Du Lac, WI 54935 2013-10-18
1144516030 Bonnie Kay Mallon Registered Nurse 118 E 9th St, Fond Du Lac, WI 54935 2011-06-20
1770885600 Holly Shepard Counselor 23 W Scott St., Fond Du Lac, WI 54935 2010-11-29
1437479110 Ruth Marie Bohn Occupational Therapy Assistant 244 North Macy Street, Fond Du Lac, WI 54935 2010-06-04
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Taxonomy Information

Taxonomy Code 207PE0004X
Grouping Allopathic & Osteopathic Physicians
Classification Emergency Medicine
Specialization Emergency Medical Services

Taxonomy Definition

An emergency medicine physician who specializes in non-hospital based emergency medical services (e.g., disaster site, accident scene, transport vehicle, etc.) to provide pre-hospital assessment, treatment, and transport patients.
Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A Certification of Added Qualifications (CAQ) is issued by the American Osteopathic Board of Emergency Medicine.

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1144703653 Quinton Jarrett Peters Emergency Medicine 1204 S Jefferson St, Appleton, WI 54915-1726 2018-09-11
1497792139 John A Culp Emergency Medicine 1446 N Randall Ave, Janesville, WI 53545-1122 2006-06-01
1861440505 Alice C Bustos Emergency Medicine 7220 W National Ave, West Allis, WI 53214-4734 2006-05-05
1184690133 Manuel A. Rivera Emergency Medicine 5000 Memorial Dr, Two Rivers, WI 54241-3900 2006-02-28
1942588132 Watertown Regional Medical Center, Inc Emergency Medicine 125 Hospital Dr, Watertown, WI 53098-3303 2011-07-22
1366692287 James John Macneal Emergency Medicine 1000 Mineral Point Ave, Janesville, WI 53548-2940 2008-09-28
1770646721 Larry R Brunzlick Emergency Medicine 135 South Gibson Street, Medford, WI 54451 2006-12-19
1669563763 Scott A Hathaway Emergency Medicine 309 N Bartlett St, Shawano, WI 54166-2127 2006-09-27
1639279383 Rajeshwar Hanmiah Emergency Medicine 309 N Bartlett St, Shawano, WI 54166-2127 2006-09-23
1598863334 George E Vidalakis Emergency Medicine 309 N Bartlett St, Shawano, WI 54166-2127 2006-09-20
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Competitor

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City FOND DU LAC
Zip Code 54935

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Dataset Information

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.

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