Active NPI
Joan Zinkgraf Handeland, MD
- Pediatrics Physician
- Green Bay, WI
National Provider Identifier
1952334245
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 27219
- Practice address
- 1821 S Webster Ave
Green Bay, WI 54301-2253 - Phone
- (920) 496-4700
- Fax
- (920) 431-1970
- NPI assigned
- Jul 9, 2006
- Last updated
- Jul 24, 2008
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 27219 | WI | Primary |
Addresses
Primary practice location
1821 S Webster Ave
Green Bay, WI 54301-2253
Mailing address
PO Box 19070
Prevea Health
Green Bay, WI 54307-9070
Phone (920) 496-4700
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 30853700 | 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
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20070417000420 | WI | Practitioner - Pediatric Medicine | 5496850687 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 27219 | WI | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Liz Hanson Will, LLC | Past | Accepting new patients |
Interoperability endpoints
- jhandeland891848@direct.emplifyhealth.org
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152403200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1216857600000",
"number": "1952334245",
"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": "920-431-1970"
},
{
"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": "920-431-1970"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HANDELAND",
"first_name": "JOAN",
"middle_name": "ZINKGRAF",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-09",
"last_updated": "2008-07-24",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "WI",
"license": "27219",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "30853700",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Green Bay, WI
- Pamela Kay Hammock, APRN, FNP-BC
- Rexann Hammons, LPN
- Katie J Hampton, NP
- Andrea M Hanamann, LPC-IT
- Hand to Shoulder Center of Wisconsin, LTD.
- Heidi Handrich, M.S., CCC-SLP
- Brianna Marie Hanek, RN
- Hanger Prosthetics & Orthotics East Inc
- Hanger Prosthetics & Orthotics East, Inc. (Hanger Clinic)
- Rebecca Lynne Hanke, MA, LMFT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2008; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.