NPIMap

Organization Active NPI

Fountain City Surgical Associates

  • Surgery Physician
  • Fond Du Lac, WI
National Provider Identifier
1487958765
Registry record updated Dec 31, 2010
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Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
23895 Issued in WI
Legal business name
FOUNTAIN CITY SURGICAL ASSOCIATES
Practice address
210 Wisconsin American Dr
Fond Du Lac, WI 54937-2999
Phone
(920) 907-7400
Fax
(920) 907-7401
NPI assigned
Dec 31, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2010

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

Authorized official

Name
Dr. Donald F Van Beek, M.D.
Title
General Surgeon
Phone
(920) 907-7400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208600000X 23895 WI Primary

Addresses

Primary practice location

210 Wisconsin American Dr
Fond Du Lac, WI 54937-2999

Mailing address

210 Wisconsin American Dr
Fond Du Lac, WI 54937-2999
Phone (920) 904-7400

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1293753600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1293753600000",
    "number": "1487958765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 WISCONSIN AMERICAN DR",
            "city": "FOND DU LAC",
            "state": "WI",
            "postal_code": "549372999",
            "telephone_number": "920-904-7400",
            "fax_number": "920-907-7401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 WISCONSIN AMERICAN DR",
            "city": "FOND DU LAC",
            "state": "WI",
            "postal_code": "549372999",
            "telephone_number": "920-907-7400",
            "fax_number": "920-907-7401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOUNTAIN CITY SURGICAL ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-31",
        "last_updated": "2010-12-31",
        "status": "A",
        "authorized_official_last_name": "VAN BEEK",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "GENERAL SURGEON",
        "authorized_official_telephone_number": "920-907-7400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "WI",
            "license": "23895",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fond Du Lac, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2010; 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.