North Shore Foot & Ankle Surgery Center, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

616-025 Issued in WI

Legal business name

NORTH SHORE FOOT & ANKLE SURGERY CENTER, LLC

Practice address

2005 S Lake Park Rd
Appleton, WI 54915-4155

Phone

(920) 882-9990

Fax

(920) 882-9544

NPI assigned

May 7, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Barry E Erdman, DPM

Title

Owner (Ceo)

Phone

(920) 882-9990

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1178496000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1315872000000",
    "number": "1184837353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2005 S LAKE PARK RD",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549154155",
            "telephone_number": "920-882-9990",
            "fax_number": "920-882-9544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2005 S LAKE PARK RD",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549154155",
            "telephone_number": "920-882-9990",
            "fax_number": "920-882-9544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH SHORE FOOT & ANKLE SURGERY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-07",
        "last_updated": "2011-09-13",
        "status": "A",
        "authorized_official_last_name": "ERDMAN",
        "authorized_official_first_name": "BARRY",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER (CEO)",
        "authorized_official_telephone_number": "920-882-9990",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "WI",
            "license": "616-025",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Norris Adarkwa Norman, M.D.
• Katie Normington, LCSW
• Brilane Norring, RN
• Mark Norris, MD
• North Appleton Dentistry, LLC
• North Shore Foot & Ankle, S.C.
• Northeast Wisconsin Foot and Ankle Assoc., S.C.
• Northeast Wisconsin Retina Associates SC
• Northeast Wisconsin Surgical Assistants, LLC
• Northern Driver, LLC

• Ambulatory Surgical Clinic/Center in Appleton, WI
• Providers in Appleton, WI by specialty
• Ambulatory Surgical Clinic/Center in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2011; 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.