Spine Neurosurgery Inst of NE Wi S.C.

Primary specialty

Neurological Surgery PhysicianTaxonomy code 207T00000X

License

39920-20 Issued in WI

Legal business name

SPINE NEUROSURGERY INST OF NE WI S.C.

Practice address

835 S Main St
Suite 1
Oconto Falls, WI 54154-1282

Phone

(920) 846-8057

Fax

(920) 846-4588

NPI assigned

Jan 26, 2006

Last updated

Oct 20, 2008By 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. Bryan M Pereira, M.D.NPI 1154391589

Title

President

Phone

(920) 846-8057

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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.

• Bryan M Pereira, M.D.

  • Neurological Surgery Physician
  • Jackson, MI
  • NPI 1154391589
  NPD (past) Authorized official

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

{
    "created_epoch": "1138233600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1224460800000",
    "number": "1528038866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3409 NICOLET DR",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543117203",
            "telephone_number": "920-846-8057",
            "fax_number": "920-846-4588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "835 S MAIN ST",
            "address_2": "SUITE 1",
            "city": "OCONTO FALLS",
            "state": "WI",
            "postal_code": "541541282",
            "telephone_number": "920-846-8057",
            "fax_number": "920-846-4588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPINE NEUROSURGERY INST OF NE WI S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-26",
        "last_updated": "2008-10-20",
        "status": "A",
        "authorized_official_last_name": "PEREIRA",
        "authorized_official_first_name": "BRYAN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "920-846-8057",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Neurological Surgery",
            "state": "WI",
            "license": "39920-20",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kaitlyn Elizabeth Sharboneau, FNP-C
• Sharpe Care Nursing & Rehabilitation Center LLC
• Julie Slempkes
• Olivia Marie Smaney, DPT
• James R Spears, MD
• James F Split, M.D.
• St Clare Memorial Hospital, Inc (St Clare Memorial Hospital Physical Therapy)
• St Clare Memorial Hospital, Inc
• St Clare Memorial Hospital, Inc (St Clare Memorial Hospital Oconto Falls Health Center)
• St Clare Memorial Hospital, Inc (St Clare Memorial Hospital Lab)

• Neurological Surgery Physician in Oconto Falls, WI
• Providers in Oconto Falls, WI by specialty
• Neurological Surgery Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2008; 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.