Delo Sport and Stem SC

Primary specialty

Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X

Legal business name

DELO SPORT AND STEM SC

Practice address

2595 Development Dr Ste 140
Green Bay, WI 54311-4267

Phone

(920) 632-7248

Fax

(920) 632-4249

NPI assigned

Aug 15, 2019

Last updated

Mar 4, 2020By 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. Marjorie Jean Delo, MDNPI 1356424691

Title

President

Phone

(920) 632-7248

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Locations

Practitioners 2

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.

• Marjorie J Delo, MD

  • Sports Medicine (Family Medicine) Physician
  • Green Bay, WI
  • NPI 1356424691
  Medicare reassignment NPD Authorized official
• Amy E Truckey, PAC, ATC

  • Physician Assistant
  • Green Bay, WI
  • NPI 1487805495
  Medicare reassignment

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

{
    "created_epoch": "1565827200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1583280000000",
    "number": "1689220527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2595 DEVELOPMENT DR STE 140",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543114267",
            "telephone_number": "920-632-7248",
            "fax_number": "920-632-4249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2595 DEVELOPMENT DR STE 140",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543114267",
            "telephone_number": "920-632-7248",
            "fax_number": "920-632-4249"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DELO SPORT AND STEM SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-15",
        "last_updated": "2020-03-04",
        "certification_date": "2020-03-04",
        "status": "A",
        "authorized_official_last_name": "DELO",
        "authorized_official_first_name": "MARJORIE",
        "authorized_official_middle_name": "JEAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "920-632-7248",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelly Delaney, RN
• Delforge Counseling LLC
• Kristin Marie Delforge
• Jacquelyn Marie Delfosse McDonald, DPT
• Tsyoshaaht Caterina Delgado, CADC III
• Marjorie J Delo, MD
• Jessica Elean Delvoye, APNP, FNP
• Joni Constance Delwiche, LCSW
• Kelly Jane Delzer, APNP, FNP-C
• Mackenzie Erin Delzer, MD

• Sports Medicine (Family Medicine) Physician in Green Bay, WI
• Providers in Green Bay, WI by specialty
• Sports Medicine (Family Medicine) Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.