STEPHEN A MASSICK (NPI# 1942282298) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942282298 |
| Entity Type | Individual |
| Full Name | STEPHEN A MASSICK |
| Credential | MD |
| Practice Address |
420 E Division St Fond Du Lac WI 54935-4560 |
| Practice Telephone | 9209268450 |
| Mailing Telephone | 9209268340 |
| Enumeration Date | 2005-11-14 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207V00000X | Obstetrics & Gynecology | 17064 | WI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | DEAN | 12583 | 01 |
| WI | UNITY | 39080723604 | 01 |
| WI | JOHN DEERE | WI0146 | 01 |
| WI | TOUCHPOINT | 17064 | 01 |
| WI | 31075000 | 05 |
| 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 |
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| 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 | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346490323 | Brita C Mccullough | Obstetrics & Gynecology | 420 E Division St, Fond Du Lac, WI 54935-4560 | 2008-09-25 |
| 1174639082 | Julie M Dejong | Obstetrics & Gynecology | 420 E Division St, Fond Du Lac, WI 54935-4560 | 2006-08-22 |
| 1104836394 | Christina A Calvello | Obstetrics & Gynecology | 420 E Division St, Fond Du Lac, WI 54935-4560 | 2006-08-09 |
| 1457339616 | Jeremy M. Bell | Obstetrics & Gynecology | 210 Wisconsin American Dr, Fond Du Lac, WI 54937-2999 | 2006-01-06 |
| 1265414676 | Mary M Schultz | Obstetrics & Gynecology | 420 E Division St, Fond Du Lac, WI 54935-4560 | 2005-11-19 |
| 1356323026 | Robert J Schuster | Obstetrics & Gynecology | 420 E Division St, Fond Du Lac, WI 54935-4560 | 2005-11-17 |
| 1538141437 | Karen L Meyer | Obstetrics & Gynecology | 420 E Division St, Fond Du Lac, WI 54935-4560 | 2005-11-16 |
| 1790767739 | Barbara A Peschong | Obstetrics & Gynecology | 420 E Division St, Fond Du Lac, WI 54935-4560 | 2005-11-16 |
| 1013908664 | Sara J Riegert | Obstetrics & Gynecology | 420 E Division St, Fond Du Lac, WI 54935-4560 | 2005-11-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508326562 | Trudy Malone | Obstetrics & Gynecology | N30w29293 Hillcrest Dr, Pewaukee, WI 53072-3235 | 2019-03-24 |
| 1114486990 | Claire Leone Wendland | Obstetrics & Gynecology | 1180 Observatory Dr, Madison, WI 53706-1320 | 2019-03-19 |
| 1407218894 | Caroline Eleonora Bednarski | Obstetrics & Gynecology | 9555 76th St # 4105, Pleasant Prairie, WI 53158-1984 | 2016-03-24 |
| 1992162929 | Hudson Physicians, S.c | Obstetrics & Gynecology | 1617 E Division St Ste 100, River Falls, WI 54022-1571 | 2016-01-21 |
| 1215324439 | Katherine Elizabeth Roberts | Obstetrics & Gynecology | 4655 N Port Washington Rd Ste 100, Glendale, WI 53212-1070 | 2015-04-26 |
| 1063809416 | Tyler Boschuetz | Obstetrics & Gynecology | 19475 W North Ave Ste 400, Brookfield, WI 53045-4199 | 2015-04-23 |
| 1548656168 | Ashley D. Durward | Obstetrics & Gynecology | 5801 Research Park Blvd Ste 400, Madison, WI 53719-6003 | 2015-04-09 |
| 1659766277 | Brandon Kuchta | Obstetrics & Gynecology | 8905 W Lincoln Ave Ste 501, West Allis, WI 53227-2470 | 2015-03-31 |
| 1194125534 | New Womens Care S C | Obstetrics & Gynecology | 855 South Main St., Oconto Falls, WI 54154 | 2014-09-03 |
| 1215348180 | Molly Kathleen Lepic | Obstetrics & Gynecology | 2402 Winnebago St # W, Madison, WI 53704-5341 | 2014-05-14 |
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| 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.