Family & Sports Orthopaedic Center, LLC

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

Legal business name

FAMILY & SPORTS ORTHOPAEDIC CENTER, LLC

Practice address

620 W Brown St
Waupun, WI 53963-1702

Phone

(920) 356-1000

Fax

(920) 356-0719

NPI assigned

Jun 16, 2008

Organization subpart

No

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

Authorized official

Name

Cindy Duerst

Title

Office Manager

Phone

(920) 356-1000

Specialties & licenses 1

Addresses

Other identifiers 10

Tax ID family

Family Sports Orthopaedic Center LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Family & Sports Orthopaedic Center LLC

  • Orthopaedic Surgery Physician
  • Beaver Dam, WI
  • NPI 1730340514
  NPD tax ID
• Family & Sports Orthopaedic Center, LLC

  • Orthopaedic Surgery Physician
  • Columbus, WI
  • NPI 1841451622
  NPD tax ID

Practitioners 3

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

• David C Barton, DO

  • Specialist
  • Beaver Dam, WI
  • NPI 1366555815
  NPD (past)
• Robert A Coe, MD

  • Orthopaedic Surgery Physician
  • Beaver Dam, WI
  • NPI 1932212461
  NPD (past)
• Rachel R Damon, NP

  • Nurse Practitioner
  • Fond Du Lac, WI
  • NPI 1487798070
  NPD (past)

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

{
    "created_epoch": "1213574400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213574400000",
    "number": "1649430380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "118 W MAPLE AVE",
            "city": "BEAVER DAM",
            "state": "WI",
            "postal_code": "539162104",
            "telephone_number": "920-356-1000",
            "fax_number": "920-356-0719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 W BROWN ST",
            "city": "WAUPUN",
            "state": "WI",
            "postal_code": "539631702",
            "telephone_number": "920-356-1000",
            "fax_number": "920-356-0719"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY & SPORTS ORTHOPAEDIC CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-16",
        "last_updated": "2008-06-16",
        "status": "A",
        "authorized_official_last_name": "DUERST",
        "authorized_official_first_name": "CINDY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "920-356-1000"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEAN CARE",
            "identifier": "15104",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30082300",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEAN CARE",
            "identifier": "11801",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32123200",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEAN CARE",
            "identifier": "11812",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICIANS PLUS",
            "identifier": "2033322",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "36027400",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WPS",
            "identifier": "391796912",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICIANS PLUS",
            "identifier": "1003837",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICIANS PLUS",
            "identifier": "2028274",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Janette L Drews, NP
• Richard Frank Eckerstorfer, LCSW
• Lynn Edmunds, LAT
• Larry Edwards, R.PH.
• Amy Ewerdt, RD
• Seth David Feldner, PTA
• Jasmine Felix, PSY.D.
• Kevin Joseph Fessler, PHARM.D.
• Connie Lynn Fiegel, OTR
• Jodi Fields, APNP-C

• Orthopaedic Surgery Physician in Waupun, WI
• Providers in Waupun, WI by specialty
• Orthopaedic Surgery Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 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.