Anthony James Cousineau, MD

Primary specialty

Pediatric Cardiology PhysicianTaxonomy code 2080P0202X

License

34459 Issued in WI

Practice address

1821 S Webster Ave
Green Bay, WI 54301-2253

Phone

(920) 496-4700

Fax

(920) 436-1319

NPI assigned

Jul 14, 2006

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

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1216771200000",
    "number": "1720004880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19070",
            "address_2": "PREVEA HEALTH",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543079070",
            "telephone_number": "920-496-4700",
            "fax_number": "920-436-1319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1821 S WEBSTER AVE",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543012253",
            "telephone_number": "920-496-4700",
            "fax_number": "920-436-1319"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COUSINEAU",
        "first_name": "ANTHONY",
        "middle_name": "JAMES",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-14",
        "last_updated": "2008-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "WI",
            "license": "34459",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "31929900",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• County of Brown
• County of Brown
• County of Brown
• County Rescue Services, Inc.
• Christina Courtney
• Herbert S Coussons, MD
• Mitchell Andrew Coval, DNP CRNA
• Chelsea Cox, DPT
• Edward Anthony Cox IV, D.C.
• Jennifer Ann Cox, LCSW

• Pediatric Cardiology Physician in Green Bay, WI
• Providers in Green Bay, WI by specialty
• Pediatric Cardiology Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2008; 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.