NPIMap

Organization Active NPI

Sports Medicine & Orthpedic Center

  • Specialist
  • Franklin, WI
National Provider Identifier
1235303561
Registry record updated Jan 8, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
SPORTS MEDICINE & ORTHPEDIC CENTER
Practice address
10101 S 27TH Street
Franklin, WI 53132
Phone
(414) 647-0033
Fax
(414) 647-0079
NPI assigned
Apr 17, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2009

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

Authorized official

Name
William J Pauers
Title
Executive Director
Phone
(414) 647-0033

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X Primary

Addresses

Primary practice location

10101 S 27TH Street
Franklin, WI 53132

Mailing address

3033 W Layton Ave
Suite 102
Greenfield, WI 53221-2628
Phone (414) 647-0033

Other identifiers 1

IdentifierTypeStateIssuer
32685200MedicaidWI

National Provider Directory

National Provider Directory
Tax ID family
Sports Medicine Orthopedic Center SC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

NPI Registry JSON

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

{
    "created_epoch": "1208390400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1231372800000",
    "number": "1235303561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3033 W LAYTON AVE",
            "address_2": "SUITE 102",
            "city": "GREENFIELD",
            "state": "WI",
            "postal_code": "532212628",
            "telephone_number": "414-647-0033",
            "fax_number": "414-647-0079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10101 S 27TH STREET",
            "city": "FRANKLIN",
            "state": "WI",
            "postal_code": "53132",
            "telephone_number": "414-647-0033",
            "fax_number": "414-647-0079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPORTS MEDICINE & ORTHPEDIC CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-17",
        "last_updated": "2009-01-08",
        "status": "A",
        "authorized_official_last_name": "PAUERS",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "414-647-0033"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32685200",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Franklin, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2009; 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.