Integrity Medical Group, S.C.

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

27767-020 Issued in WI

Legal business name

INTEGRITY MEDICAL GROUP, S.C.

Practice address

1370 N. Shawano St
Ste a
New London, WI 54961-7943

Phone

(920) 531-1100

Fax

(920) 531-8310

NPI assigned

Jun 17, 2006

Last updated

Sep 3, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Timothy B Rasor, M.D.

Title

President

Phone

(920) 982-2491

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• New London Emergency Physicians. S.c. Former legal business name

Locations

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

{
    "created_epoch": "1150502400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1251936000000",
    "number": "1376588244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1370 N. SHAWANO ST",
            "address_2": "STE A",
            "city": "NEW LONDON",
            "state": "WI",
            "postal_code": "549617943",
            "telephone_number": "920-531-1100",
            "fax_number": "920-531-8310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1370 N. SHAWANO ST",
            "address_2": "STE A",
            "city": "NEW LONDON",
            "state": "WI",
            "postal_code": "549617943",
            "telephone_number": "920-531-1100",
            "fax_number": "920-531-8310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRITY MEDICAL GROUP, S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-17",
        "last_updated": "2009-09-03",
        "status": "A",
        "authorized_official_last_name": "RASOR",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "920-982-2491",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "WI",
            "license": "27767-020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "21302700",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "New London Emergency Physicians. S.c.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Brian Woongki Hong, M.D.
• Lauren Elizabeth Honsinger, APNP
• Carrie Hostettler, COTA
• Timothy Houlihan, MD
• Insight Health Associates S.C.
• Kimberly Ileana Jacobs, OTR
• Carissa Marie Jaecks, D.C.
• Sherry Lynn Jagiello, OTA
• Deborah Jalling, LAT
• Erika Janssen

• General Practice Physician in New London, WI
• Providers in New London, WI by specialty
• General Practice Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 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.