NPIMap

Organization Active NPI

Orthopedic and Sports Institute of the Fox Valley S C

Doing business as Orthopedic Clinic of Appleton

  • Orthopaedic Surgery Physician
  • Appleton, WI
National Provider Identifier
1003836867
Registry record updated Nov 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
ORTHOPEDIC AND SPORTS INSTITUTE OF THE FOX VALLEY S C
Doing business as
Orthopedic Clinic of Appleton
Practice address
2105 E Enterprise Ave
Appleton, WI 54913-7862
Phone
(920) 560-1000
Fax
(920) 731-7133
NPI assigned
Jul 21, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2025

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

Authorized official

Name
David Allen EggertNPI 1821026188
Title
Medical Doctor
Phone
(920) 560-1000

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207X00000X Primary

Addresses

Primary practice location

2105 E Enterprise Ave
Appleton, WI 54913-7862

Mailing address

2105 E Enterprise Ave
Appleton, WI 54913-7862
Phone (920) 560-1000

Other practice location 1

102 Grand Seasons Dr Ste 1
Waupaca, WI 54981-8298
Phone (920) 560-1000

Other practice location 2

402 Eureka St
Ripon, WI 54971-1103
Phone (920) 560-1000

Other practice location 3

212 E Green Bay St Ste B
Shawano, WI 54166-2472
Phone (920) 560-1000

Other practice location 4

1498 W South Park Ave
Oshkosh, WI 54902-6677
Phone (920) 560-1000

Other identifiers 1

IdentifierTypeStateIssuer
34294100MedicaidWI

Other names 1

  • Orthopedic Clinic of Appleton Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20060509000877 WI Part B Supplier - Clinic/Group Practice 8628089331 Receives reassigned benefits from 13 practitioners
Practice locations: Appleton, WI; Oshkosh, WI; Ripon, WI; Shawano, WI; Waupaca, WI
O20201201002187 WI DME Supplier - Physician - Orthopedic/Orthopedic Surgery 8628089331 Practice locations: Appleton, WI

National Provider Directory

National Provider Directory

Locations

2105 E Enterprise Ave
Appleton, WI 54913
Phone (920) 560-1000

2105 E Enterprise Ave
Ste 113
Appleton, WI 54913
Phone (920) 560-1083

1716 Lawrence Dr
De Pere, WI 54115
Phone (920) 425-3704

1498 W South Park Ave
Oshkosh, WI 54902
Phone (920) 560-1000

102 Grand Seasons Dr
Ste 6
Waupaca, WI 54981

102 Grand Seasons Dr
Waupaca, WI 54981
Phone (715) 256-3408

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/EBJABD

Practitioners & affiliated clinicians

Practitioners 21

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1762128000000",
    "number": "1003836867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2105 E ENTERPRISE AVE",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549137862",
            "telephone_number": "920-560-1000",
            "fax_number": "920-731-7133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2105 E ENTERPRISE AVE",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549137862",
            "telephone_number": "920-560-1000",
            "fax_number": "920-731-7133"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "102 Grand Seasons Dr Ste 1",
            "address_purpose": "LOCATION",
            "city": "Waupaca",
            "state": "WI",
            "postal_code": "549818298",
            "country_code": "US",
            "telephone_number": "920-560-1000",
            "fax_number": "920-731-6732",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "402 Eureka St",
            "address_purpose": "LOCATION",
            "city": "Ripon",
            "state": "WI",
            "postal_code": "549711103",
            "country_code": "US",
            "telephone_number": "920-560-1000",
            "fax_number": "920-731-6732",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "212 E Green Bay St Ste B",
            "address_purpose": "LOCATION",
            "city": "Shawano",
            "state": "WI",
            "postal_code": "541662472",
            "country_code": "US",
            "telephone_number": "920-560-1000",
            "fax_number": "920-731-6732",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1498 W South Park Ave",
            "address_purpose": "LOCATION",
            "city": "Oshkosh",
            "state": "WI",
            "postal_code": "549026677",
            "country_code": "US",
            "telephone_number": "920-560-1000",
            "fax_number": "920-731-6732",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ORTHOPEDIC AND SPORTS INSTITUTE OF THE FOX VALLEY S C",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-21",
        "last_updated": "2025-11-03",
        "certification_date": "2025-11-03",
        "status": "A",
        "authorized_official_last_name": "EGGERT",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "ALLEN",
        "authorized_official_title_or_position": "MEDICAL DOCTOR",
        "authorized_official_telephone_number": "920-560-1000"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "34294100",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Orthopedic Clinic of Appleton",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Appleton, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.