NPIMap

Organization Active NPI

Excel Orthopedics, LTD.

  • Orthopaedic Surgery Physician
  • Beaver Dam, WI
National Provider Identifier
1366554487
Registry record updated Mar 26, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
EXCEL ORTHOPEDICS, LTD.
Practice address
705 S University Ave
Ste 150
Beaver Dam, WI 53916-3071
Phone
(920) 885-2663
Fax
(920) 885-2466
NPI assigned
Aug 31, 2006
Last updated
Mar 26, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2014

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

Authorized official

Name
Mr. Mark L Adams
Title
Practice Manager
Phone
(920) 885-2663

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X Primary

Addresses

Primary practice location

705 S University Ave
Ste 150
Beaver Dam, WI 53916-3071

Mailing address

705 S University Ave
Ste 150
Beaver Dam, WI 53916-3071
Phone (920) 885-2663

Other identifiers 1

IdentifierTypeStateIssuer
32871500MedicaidWI

Other names 1

  • Beaver Dam Orthopaedic Clinic, Ltd. Former legal business name

National Provider Directory

National Provider Directory

Locations

1515 Park Ave
#F
Columbus, WI 53925

2639 New Pinery Rd
Portage, WI 53901
Phone (608) 742-9356

Practitioners & affiliated clinicians

Practitioners 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1395792000000",
    "number": "1366554487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "705 S UNIVERSITY AVE",
            "address_2": "STE 150",
            "city": "BEAVER DAM",
            "state": "WI",
            "postal_code": "539163071",
            "telephone_number": "920-885-2663",
            "fax_number": "920-885-2466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 S UNIVERSITY AVE",
            "address_2": "STE 150",
            "city": "BEAVER DAM",
            "state": "WI",
            "postal_code": "539163071",
            "telephone_number": "920-885-2663",
            "fax_number": "920-885-2466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXCEL ORTHOPEDICS, LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2014-03-26",
        "status": "A",
        "authorized_official_last_name": "ADAMS",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "920-885-2663",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32871500",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Beaver Dam Orthopaedic Clinic, Ltd.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Beaver Dam, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2014; 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.