NPIMap

Organization Active NPI

Family & Sports Orthopaedic Center, LLC

  • Specialist
  • Beaver Dam, WI
National Provider Identifier
1467565978
Registry record updated Mar 2, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
36330 Issued in WI
Legal business name
FAMILY & SPORTS ORTHOPAEDIC CENTER, LLC
Practice address
118 W Maple Ave
Beaver Dam, WI 53916-2104
Phone
(920) 356-1000
Fax
(920) 356-0719
NPI assigned
Aug 17, 2006
Last updated
Mar 2, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2011

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

Authorized official

Name
Dr. Robert A Coe, MDNPI 1932212461
Title
Member
Phone
(920) 356-1000

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 36330 WI Primary

Addresses

Primary practice location

118 W Maple Ave
Beaver Dam, WI 53916-2104

Mailing address

118 W Maple Ave
Beaver Dam, WI 53916-2104
Phone (920) 356-1000

National Provider Directory

National Provider Directory

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": "1155772800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1299024000000",
    "number": "1467565978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "118 W MAPLE AVE",
            "city": "BEAVER DAM",
            "state": "WI",
            "postal_code": "539162104",
            "telephone_number": "920-356-1000",
            "fax_number": "920-356-0719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "118 W MAPLE AVE",
            "city": "BEAVER DAM",
            "state": "WI",
            "postal_code": "539162104",
            "telephone_number": "920-356-1000",
            "fax_number": "920-356-0719"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY & SPORTS ORTHOPAEDIC CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-17",
        "last_updated": "2011-03-02",
        "status": "A",
        "authorized_official_last_name": "COE",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "920-356-1000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "WI",
            "license": "36330",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 2, 2011; 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.