Organization Active NPI

Synergy Medical Services LLC

  • Family Medicine Physician
  • Green Bay, WI
National Provider Identifier
1366820904
Registry record updated Mar 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
44378-20 Issued in WI
Legal business name
SYNERGY MEDICAL SERVICES LLC
Practice address
2480 Marina Cir Unit 114
Green Bay, WI 54304-4875
Phone
(920) 360-6282
Fax
(920) 283-1278
NPI assigned
May 15, 2015
Last updated
Mar 9, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2021

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

Authorized official

Name
James M Williams, MDNPI 1407849433
Title
Owner / President
Phone
(920) 573-2107

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
Family Medicine Physician 207Q00000X 44378-20 WI Primary

Addresses

Primary practice location

2480 Marina Cir Unit 114
Green Bay, WI 54304-4875

Mailing address

2480 Marina Cir Unit 114
Green Bay, WI 54304-4875
Phone (920) 360-6282

Other practice location 1

424 Ernest St
Green Lake, WI 54941-9501
Phone (920) 573-2107

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150811004371 WI Part B Supplier - Clinic/Group Practice 5294056743 Receives reassigned benefits from 5 practitioners
Practice locations: Green Bay, WI; Greenville, WI; Hobart, WI; Howard, WI; Kaukauna, WI; Luxemburg, WI; Marinette, WI; Menasha, WI…

National Provider Directory

National Provider Directory

Locations

140 S Mayflower Dr
Appleton, WI 54914
Phone (920) 991-9070

1550 Arcadian Ln
De Pere, WI 54115
Phone (920) 339-0601

1880 Scheuring Rd
De Pere, WI 54115
Phone (820) 351-0719

2366 Oak Ridge Cir
De Pere, WI 54115
Phone (920) 338-1111

1229 S Jackson St
Green Bay, WI 54301
Phone (920) 437-6523

713 Cardinal Ln
Green Bay, WI 54313
Phone (920) 434-9600

E426 County Road SS
Luxemburg, WI 54217
Phone (920) 866-2010

1461 Kenwood Dr
Menasha, WI 54952
Phone (920) 886-0524

229 Van Dyke St
Oconto, WI 54153
Phone (920) 834-0302

830 Crest Dr
Pulaski, WI 54162
Phone (920) 422-4629

3136 Longview Ln
Bldg B
Suamico, WI 54173
Phone (920) 662-0470

N3501 State Road 110
Weyauwega, WI 54983
Phone (262) 420-9088

Practitioners & affiliated clinicians

Practitioners 5

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": "1431648000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1615248000000",
    "number": "1366820904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2480 MARINA CIR UNIT 114",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543044875",
            "telephone_number": "920-360-6282",
            "fax_number": "920-283-1278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2480 MARINA CIR UNIT 114",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543044875",
            "telephone_number": "920-360-6282",
            "fax_number": "920-283-1278"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "424 Ernest St",
            "address_purpose": "LOCATION",
            "city": "Green Lake",
            "state": "WI",
            "postal_code": "549419501",
            "country_code": "US",
            "telephone_number": "920-573-2107",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SYNERGY MEDICAL SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-15",
        "last_updated": "2021-03-09",
        "certification_date": "2021-03-09",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER / PRESIDENT",
        "authorized_official_telephone_number": "920-573-2107",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "44378-20",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Green Bay, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2021; 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.