Spine Capital Wisconsin LLC

Primary specialty

Neurological Surgery PhysicianTaxonomy code 207T00000X

Legal business name

SPINE CAPITAL WISCONSIN LLC

Practice address

2105 E Enterprise Ave FL 2
Appleton, WI 54913-7862

Phone

(920) 333-8878

NPI assigned

Feb 14, 2025

Organization subpart

No

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

Authorized official

Name

Dr. Robert Koffie, MDNPI 1760744460

Title

Ceo

Phone

(812) 756-8888

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Locations

Practitioners 4

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

• Robert Mawunyo Koffie, MD

  • Neurological Surgery Physician
  • Gilbert, AZ
  • NPI 1760744460

  WI

  Medicare reassignment Care Compare group NPD Authorized official
• Hillary Ann Bashaw, APNP FNP-BC

  • Nurse Practitioner
  • Appleton, WI
  • NPI 1265048805
  Medicare reassignment Care Compare group NPD
• Joseph Dominic Chabot, D.O.

  • Neurological Surgery Physician
  • Appleton, WI
  • NPI 1033421623
  Medicare reassignment Care Compare group
• John Matthew Leschke, MD

  • Neurological Surgery Physician
  • Appleton, WI
  • NPI 1164798393
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1739491200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1766448000000",
    "number": "1104621044",
    "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": "920-333-8878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2105 E ENTERPRISE AVE FL 2",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549137862",
            "telephone_number": "920-333-8878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPINE CAPITAL WISCONSIN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-02-14",
        "last_updated": "2025-12-23",
        "certification_date": "2025-12-23",
        "status": "A",
        "authorized_official_last_name": "KOFFIE",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "812-756-8888",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Neurological Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David L Sovine, MD
• John E Sowin, M.D.
• Loreli E Spaay-Joslin, RN
• Jacklyn M Spates, APNP
• Elizabeth A Specht, APSW
• Sports Medicine Center S C
• Nicole Spradley
• Carlissa Mae Spreeman, RD
• James E Springborn, DDS
• Errol Ray Springer, MD

• Neurological Surgery Physician in Appleton, WI
• Providers in Appleton, WI by specialty
• Neurological Surgery Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 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.