Doctors Park Appleton LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

DOCTORS PARK APPLETON LLC

Practice address

3400 N Conkey St. Suite S
Appleton, WI 54911

Phone

(920) 965-0345

NPI assigned

Aug 7, 2026

Last updated

Aug 7, 2026By 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

Kevan LewisNPI 1497970560

Title

Owner

Phone

(920) 965-0345

Specialties & licenses 1

Addresses

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.

• Kevan G Lewis, MD

  • MOHS-Micrographic Surgery Physician
  • Green Bay, WI
  • NPI 1497970560
  Authorized official Same address or phone

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

{
    "created_epoch": "1786060800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1786060800000",
    "number": "1205750635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 N CONKEY ST. SUITE S",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "54911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 N CONKEY ST. SUITE S",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "54911",
            "telephone_number": "920-965-0345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOCTORS PARK APPLETON LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-08-07",
        "last_updated": "2026-08-07",
        "certification_date": "2026-07-28",
        "status": "A",
        "authorized_official_last_name": "LEWIS",
        "authorized_official_first_name": "KEVAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "920-965-0345"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erica Marie Dobberfuhl, LCSW
• Joan L. Dobberstein, P.T.
• Kate Dobberstein
• Kayla Marie Dobbs, MT-BC, NMT, WMTR
• Jamie Alexa Docea
• Jaclyn L Dodd, PTA
• William R Dodd, COTA
• Emily Dodge, DNP APRN
• Katelyn Doering, REGISTERED NURSE
• Warren Doering, R.PH.

• 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 Aug 7, 2026; 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.