Organization Active NPI

Plastic Surgery Contracting Associates, LLC

Doing business as Appleton Plastic Surgery Center

  • Plastic Surgery Physician
  • Appleton, WI
National Provider Identifier
1174217889
Registry record updated Jun 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
Legal business name
PLASTIC SURGERY CONTRACTING ASSOCIATES, LLC
Doing business as
Appleton Plastic Surgery Center
Practice address
5605 W Waterford LN
Appleton, WI 54913-8438
Phone
(920) 738-7200
Fax
(920) 273-2500
NPI assigned
Jun 6, 2023
Organization subpart
Yes
Parent organization
APPLETON PLASTIC SURGERY CENTER, SCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 6, 2023

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

Authorized official

Name
Meredith H Kiesnowski
Title
Administrator
Phone
(920) 738-7200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208200000X Primary

Addresses

Primary practice location

5605 W Waterford LN
Appleton, WI 54913-8438

Mailing address

5605 W Waterford LN
Appleton, WI 54913-8438
Phone (920) 738-7200

Other names 1

  • Appleton Plastic Surgery Center Doing business as

National Provider Directory

National Provider Directory
Part of
Appleton Plastic Surgery Center SC

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1686009600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1686009600000",
    "number": "1174217889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5605 W WATERFORD LN",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549138438",
            "telephone_number": "920-738-7200",
            "fax_number": "920-273-2500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5605 W WATERFORD LN",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549138438",
            "telephone_number": "920-738-7200",
            "fax_number": "920-273-2500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PLASTIC SURGERY CONTRACTING ASSOCIATES, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "APPLETON PLASTIC SURGERY CENTER, SC",
        "enumeration_date": "2023-06-06",
        "last_updated": "2023-06-06",
        "certification_date": "2023-06-06",
        "status": "A",
        "authorized_official_last_name": "KIESNOWSKI",
        "authorized_official_first_name": "MEREDITH",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "920-738-7200"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Plastic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Appleton Plastic Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Appleton, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2023; 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.