Active NPI
Academic Maternal-Fetal Medicine Consultants SC
- Maternal & Fetal Medicine Physician
- Green Bay, WI
National Provider Identifier
1619992179
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Maternal & Fetal Medicine Physician
- Legal business name
- ACADEMIC MATERNAL-FETAL MEDICINE CONSULTANTS SC
- Practice address
- 835 S Van Buren St
Green Bay, WI 54301-3526 - Phone
- (920) 433-8265
- NPI assigned
- Jul 13, 2006
- Last updated
- Aug 22, 2020
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Susan L Sipes, M.D.
- Title
- President
- Phone
- (920) 433-8265
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Maternal & Fetal Medicine Physician | 207VM0101X | Primary |
Addresses
Primary practice location
835 S Van Buren St
Green Bay, WI 54301-3526
Mailing address
200 E Washington St
P O Box 8031
Appleton, WI 54911-5490
Phone (800) 236-1412
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 32397900 | Medicaid | WI |
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152748800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1619992179",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 E WASHINGTON ST",
"address_2": "P O BOX 8031",
"city": "APPLETON",
"state": "WI",
"postal_code": "549115490",
"telephone_number": "800-236-1412",
"fax_number": "920-739-0124"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "835 S VAN BUREN ST",
"city": "GREEN BAY",
"state": "WI",
"postal_code": "543013526",
"telephone_number": "920-433-8265"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ACADEMIC MATERNAL-FETAL MEDICINE CONSULTANTS SC",
"organizational_subpart": "NO",
"enumeration_date": "2006-07-13",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "SIPES",
"authorized_official_first_name": "SUSAN",
"authorized_official_middle_name": "L",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "920-433-8265",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "207VM0101X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology, Maternal & Fetal Medicine",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "32397900",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Green Bay, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.