NPIMap

Organization Active NPI

Breast Surgery Experts of Northeast Wisconsin, LLC

  • Surgery Physician
  • Neenah, WI
National Provider Identifier
1770810947
Registry record updated Nov 10, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
39597-20 Issued in WI
Legal business name
BREAST SURGERY EXPERTS OF NORTHEAST WISCONSIN, LLC
Practice address
130 2ND St
Neenah, WI 54956-2883
Phone
(920) 729-3100
NPI assigned
Nov 10, 2009
Last updated
Nov 10, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2009

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

Authorized official

Name
Colette A. Salm-Schmid, M.D.
Title
President
Phone
(920) 621-2880

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 39597-20 WI Primary

Addresses

Primary practice location

130 2ND St
Neenah, WI 54956-2883

Mailing address

3048 Cornelius CT
Green Bay, WI 54311-5914
Phone (920) 621-2880

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1257811200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1257811200000",
    "number": "1770810947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3048 CORNELIUS CT",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543115914",
            "telephone_number": "920-621-2880",
            "fax_number": "920-468-8969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 2ND ST",
            "city": "NEENAH",
            "state": "WI",
            "postal_code": "549562883",
            "telephone_number": "920-729-3100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BREAST SURGERY EXPERTS OF NORTHEAST WISCONSIN, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-10",
        "last_updated": "2009-11-10",
        "status": "A",
        "authorized_official_last_name": "SALM-SCHMID",
        "authorized_official_first_name": "COLETTE",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "920-621-2880",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "WI",
            "license": "39597-20",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Neenah, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2009; 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.