William Gunther Mallon, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

28182298A Issued in IN

Practice address

2149 Found Lake Rd. Box 625
Saint Germain, WI 54558-0625

Phone

(715) 542-2728

NPI assigned

Oct 23, 2006

Last updated

Mar 22, 2010By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Holy Family Memorial Inc

  dba Froedtert Holy Family Memorial Hospital

  • General Acute Care Hospital
  • Manitowoc, WI
  • NPI 1700998697
  NPD (past)
• American Anesthesiology of Minnesota, P.a.

  • Anesthesiology Physician
  • Minneapolis, MN
  • NPI 1588669840

  Nurse Anesthetist, Certified Registered

  NPD (past)
• Covenant Medical Center, Inc

  • Family Medicine Physician
  • Saginaw, MI
  • NPI 1619412376
  NPD (past)
• Kalamazoo Anesthesiology P C

  • Anesthesiology Physician
  • Kalamazoo, MI
  • NPI 1407821796
  NPD (past)
• Laboratory Corportation of America Holdings

  • Clinical Medical Laboratory
  • Clinton, IN
  • NPI 1194140293
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1269216000000",
    "number": "1013090885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 625",
            "city": "SAINT GERMAIN",
            "state": "WI",
            "postal_code": "545580625",
            "telephone_number": "715-542-2728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2149 FOUND LAKE RD. BOX 625",
            "city": "SAINT GERMAIN",
            "state": "WI",
            "postal_code": "545580625",
            "telephone_number": "715-542-2728"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALLON",
        "first_name": "WILLIAM",
        "middle_name": "GUNTHER",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-23",
        "last_updated": "2010-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "WI",
            "license": "137583-030",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MI",
            "license": "470412917",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IN",
            "license": "28182298A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephen Joseph Borak, D.C.
• Marian V. Carlson, L.P.N.
• Headwaters Family Chiropractic LLC
• Ridge Hokens, DPT
• Impact Counseling Services, LLC (ICS-Family Partners)
• New Horizons Counseling and Family Services, LLC
• Newcap, Inc.
• Northwoods PT Holdings (Northwoods Physio Therapy Services)
• Carie Satterburg, OMT
• Adam C Schenkenberg, LPN

• Certified Registered Nurse Anesthetist in Saint Germain, WI
• Providers in Saint Germain, WI by specialty
• Certified Registered Nurse Anesthetist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.