Organization Active NPI

Orthopedic Surgery Center of the Fox Valley LLC

  • Ambulatory Surgical Clinic/Center
  • Neenah, WI
National Provider Identifier
1164056974
Registry record updated Jan 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
ORTHOPEDIC SURGERY CENTER OF THE FOX VALLEY LLC
Practice address
1205 W American Dr
Neenah, WI 54956-1405
Phone
(920) 965-6382
NPI assigned
Mar 2, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2025

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

Authorized official

Name
Sandy Fragale
Title
Board Chair
Phone
(920) 965-9520

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X Primary

Addresses

Primary practice location

1205 W American Dr
Neenah, WI 54956-1405

Mailing address

2223 Lime Kiln Rd Ste 1
Green Bay, WI 54311-6213
Phone (920) 965-6382

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200526000233 WI Part B Supplier - Ambulatory Surgical Center 5597186775 Practice locations: Neenah, WI

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Orthopedic Surgery Center of the Fox Valley LLCCCN 52C0001128
Medicare certification status
ActiveFrom the Provider of Services file

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
52D2192975Orthopedic Surgery Center of the Fox Valley, LLC1205 W American Dr, Neenah, WI 54956Certificate of waiverSep 15, 2026

National Provider Directory

National Provider Directory

Locations

1205 West American Dr
Neenah, WI 54956
Phone (920) 727-8144

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1583107200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737504000000",
    "number": "1164056974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2223 LIME KILN RD STE 1",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543116213",
            "telephone_number": "920-965-6382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1205 W AMERICAN DR",
            "city": "NEENAH",
            "state": "WI",
            "postal_code": "549561405",
            "telephone_number": "920-965-6382"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORTHOPEDIC SURGERY CENTER OF THE FOX VALLEY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-02",
        "last_updated": "2025-01-22",
        "certification_date": "2025-01-22",
        "status": "A",
        "authorized_official_last_name": "FRAGALE",
        "authorized_official_first_name": "SANDY",
        "authorized_official_title_or_position": "BOARD CHAIR",
        "authorized_official_telephone_number": "920-965-9520"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Neenah, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.