JACOB R WARRENS (NPI# 1972925790) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972925790 |
| Entity Type | Individual |
| Full Name | JACOB R WARRENS |
| Credential | PA |
| Practice Address |
964 W Ryan St Suite B Brillion WI 54110-1517 |
| Mailing Address |
Po Box 22487 Green Bay WI 54305-2487 |
| Practice Telephone | 9207562055 |
| Mailing Telephone | 9204457210 |
| Mailing Fax Number | 9204457289 |
| Enumeration Date | 2014-01-14 |
| Last Update Date | 2016-01-14 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
964 W RYAN ST SUITE B |
| City | BRILLION |
| State | WI |
| Zip Code | 54110-1517 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093799686 | Christopher John Sipple | Family Medicine | 964 W Ryan St, Suite B, Brillion, WI 54110-1076 | 2005-12-06 |
| 1023403821 | Vernon Goin | Dentist | 964 W Ryan St, Suite D, Brillion, WI 54110-1076 | 2015-03-30 |
| 1679729834 | Bel-regional Home Medical Inc | Eyewear Supplier (Equipment, not the service) | 964 W Ryan St, Suite E, Brillion, WI 54110 | 2008-08-07 |
| 1396911335 | Janet A Matuszak | Physical Therapist | 964 W Ryan St, Suite B, Brillion, WI 54110-1076 | 2008-04-30 |
| 1891963112 | Bellin Memorial Hospital Inc | Optometrist | 964 W Ryan St, Suite E, Brillion, WI 54110 | 2008-02-20 |
| 1699971978 | Holly Lynn Pautz | Physician Assistant | 964 W Ryan St, Suite B, Brillion, WI 54110-1076 | 2007-06-25 |
| 1497896492 | Vernon J. Goin D.d.s. S.c. | Clinic/Center | 964 W Ryan St, Suite D, Brillion, WI 54110-1076 | 2007-02-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427691096 | Richelle L. Bruette | Technician | 306a Lavesta Ct., Brillion, WI 54110 | 2019-10-25 |
| 1659913614 | Emily M. Rataichek | Technician | 306a La Vesta Ct., Brillion, WI 54110 | 2019-10-11 |
| 1548457757 | Community Eyecare Inc | Optometrist | 950 W Ryan St, Suite A, Brillion, WI 54110 | 2007-10-02 |
| 1629120589 | Jeffery S Wierichs | Chiropractor | 114 N Main Street, Brillion, WI 54110 | 2007-01-18 |
| 1154478469 | Ascension Medical Group-fox Valley Wisconsin, Inc | Durable Medical Equipment & Medical Supplies | 708 W. Ryan St., Brillion, WI 54110 | 2007-01-05 |
| 1659377828 | Kanwar Arora | Internal Medicine | 133 Wisconsin Ave, Brillion, WI 54110 | 2005-06-22 |
| 1306004692 | Ascension Medical Group-fox Valley Wisconsin, Inc | Clinic/Center | 708 W Ryan St, Brillion, WI 54110 | 2008-05-23 |
| 1104978055 | T.j. Kalies | Chiropractor | 114 N Main Street, Brillion, WI 54110 | 2007-01-18 |
| 1376821629 | Shopko Stores Operating Co LLC | Eyewear Supplier (Equipment, not the service) | 1010 W Ryan St, Brillion, WI 54110-0000 | 2011-08-03 |
| 1588817092 | Amy Lynn Fischer | Registered Nurse | 618 Lee Ave, Brillion, WI 54110-1015 | 2008-10-28 |
| Find all providers in zip 54110 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699971978 | Holly Lynn Pautz | Physician Assistant | 964 W Ryan St, Suite B, Brillion, WI 54110-1076 | 2007-06-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043811409 | Kristen T Razner | Physician Assistant | 2500 E Capitol Dr # 3700, Appleton, WI 54911-8735 | 2020-11-03 |
| 1659986677 | Jordana Butler | Physician Assistant | 2105 E Enterprise Ave # 101, Appleton, WI 54913-7862 | 2020-09-15 |
| 1952916108 | Nicholas Allan Lueddecke | Physician Assistant | 101709 Fence Rd, Abbotsford, WI 54405-5400 | 2020-09-14 |
| 1073127049 | Dana Van De Hey | Physician Assistant | 616 White Birch Ct, Appleton, WI 54915-4516 | 2020-09-07 |
| 1386257194 | Harrison R Pham | Physician Assistant | 214 E Florida St Apt 526, Milwaukee, WI 53204-1657 | 2020-08-31 |
| 1366055063 | Clai Bishop Catto | Physician Assistant | 902c Tainter St, Menomonie, WI 54751-1546 | 2020-08-24 |
| 1003434978 | Benjamin Alton Cuvelier | Physician Assistant | 132 Cambridge Ave Apt 407, Waukesha, WI 53188-4788 | 2020-07-08 |
| 1366060295 | Sarah Anne Cook | Physician Assistant | 850 Brinsmere Dr, Elm Grove, WI 53122-2101 | 2020-07-07 |
| 1275159428 | Breanna Evert | Physician Assistant | 2320 Parklawn Dr # C111, Waukesha, WI 53186-2954 | 2020-06-23 |
| 1376168443 | Sadie Kolodziej | Physician Assistant | 401 Dewey Dr, Stevens Point, WI 54482-9655 | 2020-06-14 |
| Find all providers with the same taxonomy | ||||
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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.