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).
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 |
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 |
State | Issuer | Identifier | Type Code |
---|---|---|---|
MI | MI LIMITED LICENSE NUMBER | 4301106252 | 01 |
Address | Telephone Number | Fax Number |
---|---|---|
2661 County Highway I, Chippewa Falls, WI 547295407 | 7157231811 | |
900 W Clairemont Ave, Eau Claire, WI 547016122 | 7157144121 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1992326771 | Mitchell C Li | Nurse Practitioner | 177 Fort Washington Ave, New York, NY 10032-3733 | 2020-05-02 |
Street Address |
420 E DIVISION ST |
City | FOND DU LAC |
State | WI |
Zip Code | 54935-4560 |
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 |
Find all providers in the same location |
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 |
Find all providers in zip 54935 |
Taxonomy Code | 207PE0004X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Emergency Medicine |
Specialization | Emergency Medical Services |
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. |
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 |
Find all providers with the same taxonomy |
City | FOND DU LAC |
Zip Code | 54935 |
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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.