NPIMap

Organization Active NPI

Community Health Network Inc

Doing business as CHN Orthopedics & Sports Medicine

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Berlin, WI
National Provider Identifier
1740549773
Registry record updated May 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X
License
22113 Issued in WI
Legal business name
COMMUNITY HEALTH NETWORK INC
Doing business as
CHN Orthopedics & Sports Medicine
Practice address
191 Memorial Dr
Berlin, WI 54923-1241
Phone
(920) 361-2500
Fax
(920) 361-2973
NPI assigned
May 11, 2012
Last updated
May 11, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 11, 2012

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

Authorized official

Name
Jayne A Plagenz
Title
Director
Phone
(920) 361-5341

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X 22113 WI Primary

Addresses

Primary practice location

191 Memorial Dr
Berlin, WI 54923-1241

Mailing address

191 Memorial Dr
Berlin, WI 54923-1241
Phone (920) 361-2500

Other names 1

  • CHN Orthopedics & Sports Medicine Doing business as

National Provider Directory

National Provider Directory
Tax ID family
CHN Lifeskills12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

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

NPI Registry JSON

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

{
    "created_epoch": "1336694400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1336694400000",
    "number": "1740549773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "191 MEMORIAL DR",
            "city": "BERLIN",
            "state": "WI",
            "postal_code": "549231241",
            "telephone_number": "920-361-2500",
            "fax_number": "920-361-2973"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "191 MEMORIAL DR",
            "city": "BERLIN",
            "state": "WI",
            "postal_code": "549231241",
            "telephone_number": "920-361-2500",
            "fax_number": "920-361-2973"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY HEALTH NETWORK INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-11",
        "last_updated": "2012-05-11",
        "status": "A",
        "authorized_official_last_name": "PLAGENZ",
        "authorized_official_first_name": "JAYNE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "920-361-5341"
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "WI",
            "license": "22113",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CHN Orthopedics & Sports Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Berlin, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2012; 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.