Deborah Bletzinger Vandommelen, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

42945 Issued in WI

Practice address

1575 N River Center Dr
Milwaukee, WI 53212

Phone

(414) 283-8444

Fax

(414) 283-8450

NPI assigned

Aug 5, 2006

Sex

Female

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

Other names 1

• Dr. Deborah Sue Bletzinger Former name

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": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1902815673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 E WISCONSIN AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532024703",
            "telephone_number": "414-661-4405",
            "fax_number": "414-661-3915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1575 N RIVER CENTER DR",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "53212",
            "telephone_number": "414-283-8444",
            "fax_number": "414-283-8450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDOMMELEN",
        "first_name": "DEBORAH",
        "middle_name": "BLETZINGER",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-05",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "42945",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "34258200",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DEBORAH",
            "last_name": "BLETZINGER",
            "middle_name": "SUE",
            "prefix": "DR.",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Heidi H. Vanderpool, APNP, CPNP
• Susan K. Vandertie, RD CDE
• Mary F Vanderven, OTR/L
• Jaclyn Vanderwal, MD
• Trenton Vandewater, MD
• Calloway Steven Vanepern, PHARMD
• Diana Pang Dao Vang-Brostoff
• Cher Vang, PSYCHOTHERAPIST
• Choua Yang Vang
• Duachy Vang, APNP

• Family Medicine Physician in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Family Medicine Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.