Organization Active NPI

McDonough Orthopaedic and Sports Medicine Center SC

  • Durable Medical Equipment & Medical Supplies
  • Wisconsin Rapids, WI
National Provider Identifier
1609958404
Registry record updated Sep 27, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
MCDONOUGH ORTHOPAEDIC AND SPORTS MEDICINE CENTER SC
Practice address
410 Dewey St
Wisconsin Rapids, WI 54494-4715
Phone
(715) 421-5257
Fax
(715) 421-0111
NPI assigned
Oct 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2011

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

Authorized official

Name
Mr. Wayne R Christie, MD
Title
Vice President McDonough Orthopaedi
Phone
(715) 421-5257

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X Primary

Addresses

Primary practice location

410 Dewey St
Wisconsin Rapids, WI 54494-4715

Mailing address

PO Box 8075
Wisconsin Rapids, WI 54495-8075
Phone (715) 421-5257

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1161302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1317081600000",
    "number": "1609958404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8075",
            "city": "WISCONSIN RAPIDS",
            "state": "WI",
            "postal_code": "544958075",
            "telephone_number": "715-421-5257",
            "fax_number": "715-421-0111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 DEWEY ST",
            "city": "WISCONSIN RAPIDS",
            "state": "WI",
            "postal_code": "544944715",
            "telephone_number": "715-421-5257",
            "fax_number": "715-421-0111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCDONOUGH ORTHOPAEDIC AND SPORTS MEDICINE CENTER SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-20",
        "last_updated": "2011-09-27",
        "status": "A",
        "authorized_official_last_name": "CHRISTIE",
        "authorized_official_first_name": "WAYNE",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "VICE PRESIDENT MCDONOUGH ORTHOPAEDI",
        "authorized_official_telephone_number": "715-421-5257",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wisconsin Rapids, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 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.