McDonough Orthopaedic and Sports Medicine Center SC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

MCDONOUGH ORTHOPAEDIC AND SPORTS MEDICINE CENTER SC

Practice address

410 Dewey St
Wisconsin Rapids, WI 54494-4715

Phone

(715) 421-5257

Fax

(715) 421-0111

NPI assigned

Aug 26, 2005

Last updated

Mar 6, 2009By the provider in NPPES

Organization subpart

Yes

Parent organization

MCDONOUGH ORTHOPAEDIC AND SPORTS MEDICINE CENTER SCAs reported in NPPES

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

Authorized official

Name

Mr. Wayne R Christie, MD

Title

Vice President McDonough Orthopaedi

Phone

(715) 421-5257

Specialties & licenses 2

Addresses

Other identifiers 1

Part of

McDonough Orthosports

Practitioners 2

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.

• Daniel J. Janik, PT

  • Physical Therapist
  • Plover, WI
  • NPI 1851384606
  NPD (past)
• John W McDonough II, DO

  • Orthopaedic Surgery Physician
  • Wisconsin Rapids, WI
  • NPI 1700879525
  NPD (past)

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

{
    "created_epoch": "1125014400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1236297600000",
    "number": "1073506838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8075",
            "city": "WISCONSIN RAPIDS",
            "state": "WI",
            "postal_code": "544958075",
            "telephone_number": "715-421-5257",
            "fax_number": "715-421-0111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 DEWEY ST",
            "city": "WISCONSIN RAPIDS",
            "state": "WI",
            "postal_code": "544944715",
            "telephone_number": "715-421-5257",
            "fax_number": "715-421-0111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCDONOUGH ORTHOPAEDIC AND SPORTS MEDICINE CENTER SC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MCDONOUGH ORTHOPAEDIC AND SPORTS MEDICINE CENTER SC",
        "enumeration_date": "2005-08-26",
        "last_updated": "2009-03-06",
        "status": "A",
        "authorized_official_last_name": "CHRISTIE",
        "authorized_official_first_name": "WAYNE",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "VICE PRESIDENT MCDONOUGH ORTHOPAEDI",
        "authorized_official_telephone_number": "715-421-5257",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "416963000",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Pauline McCarville
• Brenda Jo McClellan-Tilson, APNP, MSN
• Karen Joan McClyman-Tischer
• McCray Chiropractic LLC
• Karla Renee McDonald, DDS
• McDonough Orthopaedic and Sports Medicine Center SC
• McDonough Orthopaedic and Sports Medicine Center SC
• McDonough Orthopaedic and Sports Medicine Center SC
• John W McDonough II, DO
• Tiffany Rae McFarland

• Durable Medical Equipment & Medical Supplies in Wisconsin Rapids, WI
• Providers in Wisconsin Rapids, WI by specialty
• Durable Medical Equipment & Medical Supplies in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2009; 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.