Organization Active NPI

Baycare Clinic, LLP

  • Orthopaedic Surgery Physician
  • Green Bay, WI
National Provider Identifier
1043970817
Registry record updated Aug 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
BAYCARE CLINIC, LLP
Practice address
1110 Kepler Dr
Green Bay, WI 54311-8306
Phone
(920) 288-5555
Fax
(920) 288-5550
NPI assigned
Dec 21, 2021
Last updated
Aug 27, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2026

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

Authorized official

Name
Taylor Konkle
Title
Payor Enrollment
Phone
(920) 301-1327

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X NU Primary

Addresses

Primary practice location

1110 Kepler Dr
Green Bay, WI 54311-8306

Mailing address

PO Box 28900
Green Bay, WI 54324-0900
Phone (920) 490-9046

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230421000821 WI DME Supplier - Physician - Orthopedic/Orthopedic Surgery 4385554328 Practice locations: Green Bay, WI

Other NPIs with the same Medicare PAC ID 7

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Linda Zaffke11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1110 Kepler Dr
Green Bay, WI 54311
Phone (920) 288-4712

NPI Registry JSON

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

{
    "created_epoch": "1640044800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1787788800000",
    "number": "1043970817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 28900",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543240900",
            "telephone_number": "920-490-9046",
            "fax_number": "920-405-8005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110 KEPLER DR",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543118306",
            "telephone_number": "920-288-5555",
            "fax_number": "920-288-5550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAYCARE CLINIC, LLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-21",
        "last_updated": "2026-08-27",
        "certification_date": "2026-08-27",
        "status": "A",
        "authorized_official_last_name": "KONKLE",
        "authorized_official_first_name": "TAYLOR",
        "authorized_official_title_or_position": "PAYOR ENROLLMENT",
        "authorized_official_telephone_number": "920-301-1327"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Green Bay, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2026; 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.