Sports Medicine & Orthopedic Center, S.C.

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

SPORTS MEDICINE & ORTHOPEDIC CENTER, S.C.

Practice address

5250 S 108TH St
Hales Corners, WI 53130-1331

Phone

(414) 647-0033

Fax

(414) 647-0079

NPI assigned

Jan 16, 2008

Organization subpart

No

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

Addresses

Other identifiers 1

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.

• Sports Medicine & Orthopedic Center, S.C.

  • Specialist
  • Franklin, WI
  • NPI 1396921714
  NPD tax ID
• Sports Medicine & Orthopedic Center, S.C.

  • Specialist
  • West Allis, WI
  • NPI 1952585432
  NPD tax ID
• Sports Medicine & Orthpedic Center

  • Specialist
  • Franklin, WI
  • NPI 1235303561
  NPD tax ID

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

{
    "created_epoch": "1200441600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1200614400000",
    "number": "1295911618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2025 W OKLAHOMA AVE",
            "address_2": "SUITE 100",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532154455",
            "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": "5250 S 108TH ST",
            "city": "HALES CORNERS",
            "state": "WI",
            "postal_code": "531301331",
            "telephone_number": "414-647-0033",
            "fax_number": "414-647-0079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPORTS MEDICINE & ORTHOPEDIC CENTER, S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-16",
        "last_updated": "2008-01-18",
        "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": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32685200",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Katherine Seidler, RN
• Ann K Sherren, BA, SAC-IT
• Shoptikal LLC
• Jon J. Sisulak, D.D.S.,M.S
• Marianne Faith Skrobiak, LPC
• Christina Marie Stallard, DNP
• Ann Elizabeth Stanton, APNP, RN
• Raquel Lynn Starke
• Mary Beth Steffens, CADC II
• Ashley Sticha Neis

• Specialist in Hales Corners, WI
• Providers in Hales Corners, WI by specialty
• Specialist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2008; 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.