Fox Valley Hematology & Oncology, S.C.

Primary specialty

Hematology & Oncology PhysicianTaxonomy code 207RH0003X

Legal business name

FOX VALLEY HEMATOLOGY & ONCOLOGY, S.C.

Practice address

614 Memorial Dr
Calumet Medical Center
Chilton, WI 53014-1568

Phone

(920) 849-7500

NPI assigned

Apr 9, 2007

Organization subpart

Yes

Parent organization

FOX VALLEY HEMATOLOGY & ONCOLOGY, S.C.As reported in NPPES

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

Authorized official

Name

Timothy F Goggins, M.D.

Title

Chief Medical Officer/Physician

Phone

(920) 749-1171

Specialties & licenses 1

Addresses

Other identifiers 2

Part of

Fox Valley Hematology O

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Avi Bar-Lev, M.D.

  • Hematology & Oncology Physician
  • Appleton, WI
  • NPI 1124163407
  NPD (past)

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

{
    "created_epoch": "1176076800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1484006400000",
    "number": "1497878854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3232 N BALLARD RD",
            "address_2": "SUITE 200",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549118804",
            "telephone_number": "920-749-9668",
            "fax_number": "920-734-5307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "614 MEMORIAL DR",
            "address_2": "CALUMET MEDICAL CENTER",
            "city": "CHILTON",
            "state": "WI",
            "postal_code": "530141568",
            "telephone_number": "920-849-7500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOX VALLEY HEMATOLOGY & ONCOLOGY, S.C.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FOX VALLEY HEMATOLOGY & ONCOLOGY, S.C.",
        "enumeration_date": "2007-04-09",
        "last_updated": "2017-01-10",
        "status": "A",
        "authorized_official_last_name": "GOGGINS",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "CHIEF MEDICAL OFFICER/PHYSICIAN",
        "authorized_official_telephone_number": "920-749-1171",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32802700",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMERC",
            "identifier": "0886830001",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lara L Devine, RN, DDS
• Dawn Marie Dohr, LPC
• Timothy J Fale
• Dennis E Fischer
• Forefront Dermatology, S.C.
• Tammy Frassetto, CSAC, CS-IT
• Katherine Lucia Gaulke, OTR/L
• Amy Gauthier, DPT
• Christine Marie Goetsch, PTA
• Amanda Hackbarth, APNP

• Hematology & Oncology Physician in Chilton, WI
• Providers in Chilton, WI by specialty
• Hematology & Oncology Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2017; 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.