Orthopedic & Spine Therapy of Clintonville, SC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

ORTHOPEDIC & SPINE THERAPY OF CLINTONVILLE, SC

Practice address

205 W. Green Bay Street
Shawano, WI 54166-2333

Phone

(715) 526-5433

Fax

(715) 526-6930

NPI assigned

Oct 4, 2006

Last updated

Jul 16, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Paul Steven Barnett, P.T.NPI 1154368777

Title

Owner/President

Phone

(920) 257-2000

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Orthopedic Spine Therapy of Clintonville SC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

• Orthopedic & Spine Therapy of Clintonville, SC

  • Physical Therapist
  • Clintonville, WI
  • NPI 1528172988
  NPD tax ID
• Orthopedic & Spine Therapy of Clintonville, SC

  • Durable Medical Equipment & Medical Supplies
  • Clintonville, WI
  • NPI 1629165071
  NPD tax ID

Practitioners 1

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.

• Paul Steven Barnett, PT

  • Physical Therapist
  • Appleton, WI
  • NPI 1154368777
  NPD (past) Authorized official

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1184544000000",
    "number": "1134214133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 N PROVIDENCE AVE",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549138018",
            "telephone_number": "920-257-2000",
            "fax_number": "920-257-2004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 W. GREEN BAY STREET",
            "city": "SHAWANO",
            "state": "WI",
            "postal_code": "541662333",
            "telephone_number": "715-526-5433",
            "fax_number": "715-526-6930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORTHOPEDIC & SPINE THERAPY OF CLINTONVILLE, SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-04",
        "last_updated": "2007-07-16",
        "status": "A",
        "authorized_official_last_name": "BARNETT",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "STEVEN",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "920-257-2000",
        "authorized_official_credential": "P.T."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "WI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41746200",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• NSH Shawano-Evergreen LLC (Evergreen Health Services)
• NSH Shawano-Maple LLC (Maple Lane Health Services)
• Thomas L Olmsted, CRNA
• Andrea Olsen, OTR
• Jill Olsen, APNP
• Orthopedic & Spine Therapy of Clintonville, SC
• Matthew James Osborne, PT
• Kirby Elizabeth Otto, APNP
• Pai Participant 23 SC
• Ann M Papendorf, APNP

• Durable Medical Equipment & Medical Supplies in Shawano, WI
• Providers in Shawano, 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 Jul 16, 2007; 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.