John P Revord (NPI# 1922090141, PAC ID# 1254317480) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PHYSICAL MEDICINE AND REHABILITATION.
| Nation Provider ID (NPI) | 1922090141 |
| PAC ID by PECOS | 1254317480 |
| Professional Enrollment ID | I20040628000745 |
| Full Name | John P Revord |
| Organization Legal Name | NEUROSPINE CENTER OF WISCONSIN, S.C. |
| Address |
5320 W Michaels Dr Appleton WI 54913-8446 |
| Phone Number | 9208828200 |
| Gender | M |
| Credential | MD |
| Medical School | UNIVERSITY OF ILLINOIS AT CHICAGO HEALTH SCIENCE CENTER |
| Graduation Year | 1988 |
| Primary Specialty | PHYSICAL MEDICINE AND REHABILITATION |
| Group Practice PAC ID | 1153217740 |
| Number of Group Practice Members | 18 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 520009 | ST ELIZABETH HOSPITAL |
| 520045 | THEDA CLARK MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 5320 W Michaels Dr, Appleton, WI 54913-8446 | 9208828200 | NEUROSPINE CENTER OF WISCONSIN, S.C. |
| Measure Identifier | Measure Title | Performance Rate | Reporting Mechanism |
|---|---|---|---|
| MIPS_EC_130_overall | Documentation of Current Medications in the Medical Record | 99% | |
| MIPS_EC_226_overall | Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention | 100% |
| Organization Legal Name | NEUROSPINE CENTER OF WISCONSIN, S.C. |
| Physicians | 18 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Jill J Buchinger | Nurse Practitioner | Neurospine Center of Wisconsin, S.c. | 700 N Westhaven Dr, Aurora, Oshkosh, WI 54904-6947 |
| Cindy J Hillesheim | Physical Therapy | Neurospine Center of Wisconsin, S.c. | 5320 W Michaels Dr, Appleton, WI 54913-8446 |
| Randall J Schultz | Physical Medicine and Rehabilitation | Neurospine Center of Wisconsin, S.c. | 700 N Westhaven Dr, Aurora, Oshkosh, WI 54904-6947 |
| Anthony K Lee | Physician Assistant | Neurospine Center of Wisconsin, S.c. | 130 2nd St, Neenah, WI 54956-2883 |
| David C De Witt | Orthopedic Surgery | Neurospine Center of Wisconsin, S.c. | 700 N Westhaven Dr, Aurora, Oshkosh, WI 54904-6947 |
| Jennifer A Heenan | Nurse Practitioner | Neurospine Center of Wisconsin, S.c. | 5320 W Michaels Dr, Appleton, WI 54913-8446 |
| Ronald S Miller | Physical Therapy | Neurospine Center of Wisconsin, S.c. | 5320 W Michaels Dr, Appleton, WI 54913-8446 |
| Karl A Greene | Neurosurgery | Neurospine Center of Wisconsin, S.c. | 5320 W Michaels Dr, Appleton, WI 54913-8446 |
| Cason M Brown | Physical Medicine and Rehabilitation | Neurospine Center of Wisconsin, S.c. | 5320 W Michaels Dr, Appleton, WI 54913-8446 |
| Thomas M Wascher | Neurosurgery | Neurospine Center of Wisconsin, S.c. | 5320 W Michaels Dr, Appleton, WI 54913-8446 |
| Street Address |
5320 W MICHAELS DR |
| City | APPLETON |
| State | WI |
| Zip | 54913-8446 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Cindy J Hillesheim | Physical Therapy | Neurospine Center of Wisconsin, S.c. | 5320 W Michaels Dr, Appleton, WI 54913-8446 |
| Jennifer A Heenan | Nurse Practitioner | Neurospine Center of Wisconsin, S.c. | 5320 W Michaels Dr, Appleton, WI 54913-8446 |
| Ronald S Miller | Physical Therapy | Neurospine Center of Wisconsin, S.c. | 5320 W Michaels Dr, Appleton, WI 54913-8446 |
| Karl A Greene | Neurosurgery | Neurospine Center of Wisconsin, S.c. | 5320 W Michaels Dr, Appleton, WI 54913-8446 |
| Cason M Brown | Physical Medicine and Rehabilitation | Neurospine Center of Wisconsin, S.c. | 5320 W Michaels Dr, Appleton, WI 54913-8446 |
| Thomas M Wascher | Neurosurgery | Neurospine Center of Wisconsin, S.c. | 5320 W Michaels Dr, Appleton, WI 54913-8446 |
| William S Bodemer | Orthopedic Surgery | Neurospine Center of Wisconsin, S.c. | 5320 W Michaels Dr, Appleton, WI 54913-8446 |
| Richard A Staehler | Physical Medicine and Rehabilitation | Neurospine Center of Wisconsin, S.c. | 5320 W Michaels Dr, Appleton, WI 54913-8446 |
| Pamela E Verkuilen | Nurse Practitioner | Neurospine Center of Wisconsin, S.c. | 5320 W Michaels Dr, Appleton, WI 54913-8446 |
| Krista A Fish | Physical Therapy | Neurospine Center of Wisconsin, S.c. | 5320 W Michaels Dr, Appleton, WI 54913-8446 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Brent R Weed | Dermatology | Forefront Dermatology Sc | 3935 N Lightning Dr, Appleton, WI 54913-6717 |
| Peter J Katz | Dermatology | Forefront Dermatology Sc | 3935 N Lightning Dr, Appleton, WI 54913-6717 |
| Marcella K Teske | Nurse Practitioner | Forefront Dermatology Sc | 3935 N Lightning Dr, Appleton, WI 54913-6717 |
| Michelle D Lewis | Dermatology | Forefront Dermatology Sc | 3935 N Lightning Dr, Appleton, WI 54913-6717 |
| Noam Littman | Diagnostic Radiology | Synergy Radiology Associates Pllc | 4528 N Grassmere Ct, Appleton, WI 54913-6809 |
| Steven J Hagen | Family Practice | Primary Care Associates of Appleton, Ltd | 3916 N Intertech Court, Appleton, WI 54913-6956 |
| Jonathan E Hagen | Family Practice | Primary Care Associates of Appleton, Ltd | 3916 N Intertech Court, Appleton, WI 54913-6956 |
| Judith M Anderson | Nurse Practitioner | Primary Care Associates of Appleton, Ltd | 3916 N Intertech Court, Appleton, WI 54913-6956 |
| Rachel Rockweiler | Physician Assistant | Primary Care Associates of Appleton, Ltd | 3916 N Intertech Ct, Appleton, WI 54913-6957 |
| Stephen C Fuller | Family Medicine | Primary Care Associates of Appleton, Ltd | 3916 N Intertech Ct, Appleton, WI 54913-6957 |
| Find all physicians in zip 54913 | |||
| City | APPLETON |
| Zip Code | 54913 |
| Specialty | PHYSICAL MEDICINE AND REHABILITATION |
| City + Specialty | APPLETON + PHYSICAL MEDICINE AND REHABILITATION |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.