NPIMap

Organization Active NPI

Wisconsin Spine and Pain SC

  • Durable Medical Equipment & Medical Supplies
  • Appleton, WI
National Provider Identifier
1285452391
Registry record updated Jan 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
WISCONSIN SPINE AND PAIN SC
Practice address
1616 N Casaloma Dr Ste 100
Appleton, WI 54913-8245
Phone
(920) 204-6758
NPI assigned
Sep 27, 2024
Last updated
Jan 23, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2026

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

Authorized official

Name
Michael JungNPI 1861665747
Title
Owner
Phone
(414) 455-1153

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X NU Primary

Addresses

Primary practice location

1616 N Casaloma Dr Ste 100
Appleton, WI 54913-8245

Mailing address

Dept CH 17057
Palatine, IL 60055-7057
Phone (920) 204-6758

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250513000600 WI DME Supplier - Physician - Interventional Pain Management 0345665469 Practice locations: Appleton, WI

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Wisconsin Spine and Pain SC5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Locations

2595 Development Dr
Ste 150
Green Bay, WI 54311
Phone (888) 901-7246

1 E Waldo Blvd
Ste 2
Manitowoc, WI 54220

1249 W Liebau Rd
Ste 200
Mequon, WI 53092
Phone (833) 821-7246

2124 Kohler Memorial Dr
Ste 110
Sheboygan, WI 53081
Phone (833) 821-7246

2607 N Grandview Blvd
Ste 102
Waukesha, WI 53188
Phone (262) 446-9981

Practitioners & affiliated clinicians

Practitioners 33

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.

View all 33

NPI Registry JSON

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

{
    "created_epoch": "1727395200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1769126400000",
    "number": "1285452391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "DEPT CH 17057",
            "city": "PALATINE",
            "state": "IL",
            "postal_code": "600557057",
            "telephone_number": "920-204-6758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1616 N CASALOMA DR STE 100",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549138245",
            "telephone_number": "920-204-6758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WISCONSIN SPINE AND PAIN SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-27",
        "last_updated": "2026-01-23",
        "certification_date": "2026-01-23",
        "status": "A",
        "authorized_official_last_name": "JUNG",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "414-455-1153"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Jan 23, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.