Organization Active NPI

Fox Valley Hematology & Oncology, S.C.

  • Hematology & Oncology Physician
  • New London, WI
National Provider Identifier
1003039959
Registry record updated Feb 7, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
Legal business name
FOX VALLEY HEMATOLOGY & ONCOLOGY, S.C.
Practice address
1370 N Shawano St E
New London, WI 54961-2155
Phone
(920) 249-7171
NPI assigned
Apr 10, 2007
Organization subpart
Yes
Parent organization
FOX VALLEY HEMATOLOGY & ONCOLOGY, S.C.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 7, 2017

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

Authorized official

Name
Timothy F Goggins, M.D.
Title
Chief Medical Officer/Physician
Phone
(920) 749-1171

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RH0003X Primary

Addresses

Primary practice location

1370 N Shawano St E
New London, WI 54961-2155

Mailing address

3232 N Ballard Rd
Suite 200
Appleton, WI 54911-8804
Phone (920) 749-9668

Other identifiers 2

IdentifierTypeStateIssuer
0886830005OtherWIDMEPOS - DMEMAC
32802700MedicaidWI

National Provider Directory

National Provider Directory
Part of
Fox Valley Hematology O

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1176163200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1486425600000",
    "number": "1003039959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3232 N BALLARD RD",
            "address_2": "SUITE 200",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549118804",
            "telephone_number": "920-749-9668",
            "fax_number": "920-734-5307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1370 N SHAWANO ST E",
            "city": "NEW LONDON",
            "state": "WI",
            "postal_code": "549612155",
            "telephone_number": "920-249-7171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOX VALLEY HEMATOLOGY & ONCOLOGY, S.C.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FOX VALLEY HEMATOLOGY & ONCOLOGY, S.C.",
        "enumeration_date": "2007-04-10",
        "last_updated": "2017-02-07",
        "status": "A",
        "authorized_official_last_name": "GOGGINS",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "CHIEF MEDICAL OFFICER/PHYSICIAN",
        "authorized_official_telephone_number": "920-749-1171",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMEPOS - DMEMAC",
            "identifier": "0886830005",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32802700",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New London, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2017; 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.