Sourasack K Vongsa (NPI# 1619945524, PAC ID# 8224051131) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is FAMILY MEDICINE.
| Nation Provider ID (NPI) | 1619945524 |
| PAC ID by PECOS | 8224051131 |
| Professional Enrollment ID | I20060106000116 |
| Full Name | Sourasack K Vongsa |
| Organization Legal Name | THEDACARE INCORPORATED |
| Address |
2500 E Capitol Dr Suite 1200 Appleton WI 54911-8735 |
| Phone Number | 8002362236 |
| Gender | M |
| Credential | MD |
| Graduation Year | 2003 |
| Primary Specialty | FAMILY MEDICINE |
| Group Practice PAC ID | 1759294887 |
| Number of Group Practice Members | 478 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 520045 | THEDA CLARK MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 2500 E Capitol Dr, Suite 1200, Appleton, WI 54911-8735 | 8002362236 | THEDACARE INCORPORATED |
| Organization Legal Name | THEDACARE INCORPORATED |
| Physicians | 485 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Andrew J Kubisch | Physician Assistant | Thedacare Incorporated | 1405 Mill St, New London, WI 54961-2155 |
| Anna L King | Physician Assistant | Thedacare Incorporated | 1818 N Meade St Room, N255, Appleton, WI 54911-3454 |
| Roger B Collins | Orthopedic Surgery | Thedacare Incorporated | 130 2nd St, Neenah, WI 54956-2883 |
| Jennifer E Szmanda | Pediatric Medicine | Thedacare Incorporated | 640 Deerwood Ave, Neenah, WI 54956-7110 |
| Elizabeth A Barthel | Nurse Practitioner | Thedacare Incorporated | 2500 E Capitol Dr, Fl 2, Appleton, WI 54911-8735 |
| Carmen L Miller | Nurse Practitioner | Thedacare Incorporated | 710 Riverside Dr, Waupaca, WI 54981-1941 |
| Kathleen M Erdahl | Nurse Practitioner | Thedacare Incorporated | 1000 W Northland Ave, Appleton, WI 54914-1419 |
| Jennifer L Kohnke | Nurse Practitioner | Thedacare Incorporated | 670 Country Rd A, Green Lake, WI 54941-8608 |
| Taylor B Doberstein | Rheumatology | Thedacare Incorporated | 200 Theda Clark Medical Plaza, Suite 350, Neenah, WI 54956-2790 |
| Rachel A Savage | Nurse Practitioner | Thedacare Incorporated | 400 S Maple St, Black Creek, WI 54106-9787 |
| Street Address |
2500 E CAPITOL DR SUITE 1200 |
| City | APPLETON |
| State | WI |
| Zip | 54911-8735 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Elizabeth A Barthel | Nurse Practitioner | Thedacare Incorporated | 2500 E Capitol Dr, Fl 2, Appleton, WI 54911-8735 |
| Lisa A Valiquette | Nurse Practitioner | Thedacare Incorporated | 2500 E Capitol Dr, Fl 2, Appleton, WI 54911-8735 |
| Sanjeevkumar A Patel | Pulmonary Disease | Fox Valley Pulmonary Medicine Sc | 2500 E Capitol Dr, Suite 1700, Appleton, WI 54911-8735 |
| Scott C Parrish | Critical Care (intensivists) | Fox Valley Pulmonary Medicine Sc | 2500 E Capitol Dr, Suite 1700, Appleton, WI 54911-8735 |
| Tammy M Flynn | Nurse Practitioner | Thedacare Incorporated | 2500 E Capitol Dr, Fl 2, Appleton, WI 54911-8735 |
| Omar Atassi | Urology | Wisconsin Institute of Urology Sc | 2500 E Capitol Dr, Suite 2600, Appleton, WI 54911-8735 |
| Michelle L Schacht | Family Medicine | Thedacare Incorporated | 2500 E Capitol Dr, Suite 3300, Appleton, WI 54911-8735 |
| Ashley Nicole Schumacher | Nurse Practitioner | Thedacare Incorporated | 2500 E Capitol Dr, Fl 2, Appleton, WI 54911-8735 |
| Angie M Schiesser | Nurse Practitioner | Thedacare Incorporated | 2500 E Capitol Dr, Suite 1300, Appleton, WI 54911-8735 |
| Gbolahan D Oyinloye | Psychiatry | Thedacare Incorporated | 2500 E Capitol Dr, Fl 2, Appleton, WI 54911-8735 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Cynthia F Susedik | Emergency Medicine | Ascension Medical Group-fox Valley Wisconsin, Inc | 3329 N Richard St, Appleton, WI 54911-1063 |
| Kenneth A Geller | Cardiovascular Disease (cardiology) | Ascension Medical Group-fox Valley Wisconsin, Inc | 3329 N Richmond St, Appleton, WI 54911-1063 |
| Christopher W Wagener | Obstetrics/gynecology | Ascension Medical Group-fox Valley Wisconsin, Inc | 3329 N Richard St, Appleton, WI 54911-1063 |
| Lance A Grammont | Family Medicine | Ascension Medical Group-fox Valley Wisconsin, Inc | 3329 N Richard St, Appleton, WI 54911-1063 |
| Nicole Gutman | Nurse Practitioner | Ascension Medical Group-fox Valley Wisconsin, Inc | 3329 N Richard St, Appleton, WI 54911-1063 |
| Charles M Miller | Family Medicine | Ascension Medical Group-fox Valley Wisconsin, Inc | 3329 N Richard St, Appleton, WI 54911-1063 |
| Gunmeet K Kaleka | Family Medicine | Ascension Medical Group-fox Valley Wisconsin, Inc | 3329 N Richard St, Appleton, WI 54911-1063 |
| Kathryn M Meyer | Obstetrics/gynecology | Ascension Medical Group-fox Valley Wisconsin, Inc | 3329 N Richard St, Appleton, WI 54911-1063 |
| John T Siebers | Nurse Practitioner | Ascension Medical Group-fox Valley Wisconsin, Inc | 3329 N Richard St, Appleton, WI 54911-1063 |
| Wesley R Meyer | Optometry | Ascension Medical Group-fox Valley Wisconsin, Inc | 3329 N Richard St, Appleton, WI 54911-1063 |
| Find all physicians in zip 54911 | |||
| City | APPLETON |
| Zip Code | 54911 |
| Specialty | FAMILY MEDICINE |
| City + Specialty | APPLETON + FAMILY MEDICINE |
Please comment or provide details below to improve the information on Sourasack K Vongsa.
| 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.