Emmanuel Esianor, PHYSICIAN ASSISTANT

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

3086-23 Issued in WI

Practice address

2800 Westhill Dr
Ste 200
Wausau, WI 54401-3771

Phone

(715) 843-1000

Fax

(715) 843-1001

NPI assigned

Oct 14, 2011

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

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

• MNR Industries LLC

  • Urgent Care Clinic/Center
  • Mount Airy, MD
  • NPI 1073963146
  NPD (past)

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

{
    "created_epoch": "1318550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1362528000000",
    "number": "1548545189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2800 WESTHILL DR",
            "address_2": "STE 200",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544013771",
            "telephone_number": "715-843-1000",
            "fax_number": "715-843-1001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 WESTHILL DR",
            "address_2": "STE 200",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544013771",
            "telephone_number": "715-843-1000",
            "fax_number": "715-843-1001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESIANOR",
        "first_name": "EMMANUEL",
        "name_prefix": "Mr.",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-10-14",
        "last_updated": "2013-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "3086-23",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "3086-23",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lori K Erdman, ANPC
• Elizabeth Blixt Erickson, LPN
• Macy Jo Erickson, MS, SLP-CF
• Thomas Ertl, PT
• Filagot Debebe Eshete, MD
• Jesse T Espe, DPT
• McKinley Kealani Espindabanick
• Kimberly J. Esterline, LCSW
• Evans Counseling, LLC
• Kelly Charles Evans, PH.D.

• Physician Assistant in Wausau, WI
• Providers in Wausau, WI by specialty
• Physician Assistant in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2013; 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.