NPIMap

Organization Active NPI

Orthopedic & Sports Medicine Specialists of Green Bay, SC

  • Specialist
  • Green Bay, WI
National Provider Identifier
1760670145
Registry record updated Apr 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
ORTHOPEDIC & SPORTS MEDICINE SPECIALISTS OF GREEN BAY, SC
Practice address
2223 Lime Kiln Rd
Suite 1
Green Bay, WI 54311-6213
Phone
(920) 430-8120
Fax
(920) 430-8122
NPI assigned
Oct 10, 2007
Last updated
Apr 28, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2023

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

Authorized official

Name
Katie Klaus
Title
Provider Credentialing and Privileg
Phone
(920) 965-9517

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X WI Primary

Addresses

Primary practice location

2223 Lime Kiln Rd
Suite 1
Green Bay, WI 54311-6213

Mailing address

2223 Lime Kiln Rd
Suite 1
Green Bay, WI 54311-6213
Phone (920) 430-8120

Other practice location 1

835 S Main St Ste 3
Oconto Falls, WI 54154-1282
Phone (920) 430-8113

Other practice location 2

1931 Marinette Ave
Marinette, WI 54143-3801
Phone (920) 430-8113

Other practice location 3

614 Memorial Dr
Chilton, WI 53014-1568
Phone (920) 430-8113

Other practice location 4

1205 W American Dr
Neenah, WI 54956-1405
Phone (920) 430-8113

Other practice location 5

2700 W 9th Ave Ste 125
Oshkosh, WI 54904-7864
Phone (920) 430-8113

Other identifiers 1

IdentifierTypeStateIssuer
21316600MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20080314000537 WI Part B Supplier - Clinic/Group Practice 9739264714 Receives reassigned benefits from 64 practitioners
Practice locations: Green Bay, WI; Ripon, WI; Oshkosh, WI; Oconto Falls, WI; Marinette, WI; Neenah, WI; Fond Du Lac, WI; Chilton, WI
O20100930068098 WI DME Supplier - Physician - Orthopedic/Orthopedic Surgery 9739264714 Practice locations: Green Bay, WI

National Provider Directory

National Provider Directory

Locations

W6184 Aerotech Dr
Unit 1
Appleton, WI 54914

1630 Commanche Ave
Ste 101
Green Bay, WI 54313
Phone (920) 430-4750

2223 Lime Kiln Rd
Ste 2
Green Bay, WI 54311
Phone (920) 569-4300

720 S Van Buren St
Ste 101
Green Bay, WI 54301
Phone (920) 430-8120

1205 West American Dr
Neenah, WI 54956
Phone (920) 727-8144

833 S Main St
Oconto Falls, WI 54154
Phone (920) 338-6866

2700 W 9th Ave
Ste 125
Oshkosh, WI 54904
Phone (800) 322-2141

Interoperability endpoints

  • Direct secure messaging: ben.zellner@osms.cernerdirect.com
  • Direct secure messaging: bryan.royce@osms.cernerdirect.com
  • Direct secure messaging: daniel.linehan@osms.cernerdirect.com
  • Direct secure messaging: darren.nabor@osms.cernerdirect.com
  • Direct secure messaging: debbie.lim@osms.cernerdirect.com
  • Direct secure messaging: douglas.miller@osms.cernerdirect.com
  • Direct secure messaging: gregory.kirwan@osms.cernerdirect.com
  • FHIR API: https://fhir-myrecord.cerner.com/r4/0cda6ed7-9e18-4112-ab11-d5a45a40c8d5/
  • Direct secure messaging: jacob.seiler@osms.cernerdirect.com
  • Direct secure messaging: jason.klein@osms.cernerdirect.com
  • Direct secure messaging: joel.hein@osms.cernerdirect.com
  • Direct secure messaging: joseph.mccormick@osms.cernerdirect.com
  • Direct secure messaging: karl.henrikson@osms.cernerdirect.com
  • Direct secure messaging: kevin.knox@osms.cernerdirect.com
  • Direct secure messaging: luke.fraundorf@osms.cernerdirect.com
  • Direct secure messaging: manpreet.sethi@osms.cernerdirect.com
  • Direct secure messaging: michael.avery@osms.cernerdirect.com
  • Direct secure messaging: michael.tressler@osms.cernerdirect.com
  • Direct secure messaging: paul.bruhnding@osms.cernerdirect.com
  • Direct secure messaging: paul.tuttle@osms.cernerdirect.com

Ownership & related parties

Subparts reporting this organization as parent 8

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 71

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.

View all 71

NPI Registry JSON

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

{
    "created_epoch": "1191974400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682640000000",
    "number": "1760670145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2223 LIME KILN RD",
            "address_2": "SUITE 1",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543116213",
            "telephone_number": "920-430-8120",
            "fax_number": "920-430-8122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2223 LIME KILN RD",
            "address_2": "SUITE 1",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543116213",
            "telephone_number": "920-430-8120",
            "fax_number": "920-430-8122"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "835 S Main St Ste 3",
            "address_purpose": "LOCATION",
            "city": "Oconto Falls",
            "state": "WI",
            "postal_code": "541541282",
            "country_code": "US",
            "telephone_number": "920-430-8113",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1931 Marinette Ave",
            "address_purpose": "LOCATION",
            "city": "Marinette",
            "state": "WI",
            "postal_code": "541433801",
            "country_code": "US",
            "telephone_number": "920-430-8113",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "614 Memorial Dr",
            "address_purpose": "LOCATION",
            "city": "Chilton",
            "state": "WI",
            "postal_code": "530141568",
            "country_code": "US",
            "telephone_number": "920-430-8113",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1205 W American Dr",
            "address_purpose": "LOCATION",
            "city": "Neenah",
            "state": "WI",
            "postal_code": "549561405",
            "country_code": "US",
            "telephone_number": "920-430-8113",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2700 W 9th Ave Ste 125",
            "address_purpose": "LOCATION",
            "city": "Oshkosh",
            "state": "WI",
            "postal_code": "549047864",
            "country_code": "US",
            "telephone_number": "920-430-8113",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ORTHOPEDIC & SPORTS MEDICINE SPECIALISTS OF GREEN BAY, SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-10",
        "last_updated": "2023-04-28",
        "certification_date": "2023-04-28",
        "status": "A",
        "authorized_official_last_name": "KLAUS",
        "authorized_official_first_name": "KATIE",
        "authorized_official_title_or_position": "PROVIDER CREDENTIALING AND PRIVILEG",
        "authorized_official_telephone_number": "920-965-9517"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "WI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "21316600",
            "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 Apr 28, 2023; 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.