Active NPI
Corey J Zeller, MD
- Family Medicine Physician
- Wild Rose, WI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 47141
- Practice address
- 701 Grove Ave
Wild Rose, WI 54984-6901 - Phone
- (920) 622-5560
- NPI assigned
- Mar 9, 2006
- Last updated
- Apr 29, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 47141 | WI | Primary |
Addresses
Primary practice location
701 Grove Ave
Wild Rose, WI 54984-6901
Mailing address
701 Grove Ave
Wild Rose, WI 54984-6901
Phone (920) 622-5560
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 207Q00000X | Medicaid | WI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- University of Wisconsin School of Medicine, 2003
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
101 Main St
Neenah, WI 54956-2570
Phone (920) 727-4200
1855 S Koeller St
Oshkosh, WI 54902-6186
Phone (920) 223-7000
3329 N Richard St
Appleton, WI 54911-1063
Phone (920) 380-2715
5000 W Chambers St
Milwaukee, WI 53210-1650
Phone (414) 447-2000
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 47141 | WI | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Thedacare, Incorporated | Family Medicine | Current | Accepting new patients |
| Emergency Medicine Specialists, S.C. | Current | Accepting new patients |
Locations
3329 N Richmond St
Appleton, WI 54911
Phone (920) 380-2715
225 Memorial Dr
Berlin, WI 54923
Phone (920) 361-1313
5000 W Chambers St
Milwaukee, WI 53210
Phone (414) 447-2089
1405 Mill St
New London, WI 54961
Phone (920) 531-2000
1855 S Koeller St
Oshkosh, WI 54902
Phone (920) 223-7010
710 Riverside Dr
Waupaca, WI 54981
Phone (715) 256-3000
10625 W North Ave
Ste 101
Wauwatosa, WI 53226
Phone (414) 858-2200
601 Grove Ave
Wild Rose, WI 54984
Phone (920) 361-5907
701 Grove Ave
Wild Rose, WI 54984
Phone (920) 361-5340
Organizations & group practices 2
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.
-
- Emergency Medicine Physician
- Milwaukee, WI
- NPI 1568413524
-
dba ThedaCare Physicians
- Family Medicine Physician
- New London, WI
- NPI 1376656959
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Ascension NE Wisconsin-St Elizabeth Campus
- General Acute Care Hospital
- Appleton, WI
- NPI 1407803638
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1141862400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1398729600000",
"number": "1710955299",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "701 GROVE AVE",
"city": "WILD ROSE",
"state": "WI",
"postal_code": "549846901",
"telephone_number": "920-622-5560"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "701 GROVE AVE",
"city": "WILD ROSE",
"state": "WI",
"postal_code": "549846901",
"telephone_number": "920-622-5560"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ZELLER",
"first_name": "COREY",
"middle_name": "J",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-09",
"last_updated": "2014-04-29",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "WI",
"license": "47141",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "207Q00000X",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Wild Rose, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.