Lindstrom Orthopedic Clinic, SC

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

22441 Issued in WI

Legal business name

LINDSTROM ORTHOPEDIC CLINIC, SC

Practice address

2105 E Enterprise Ave
Suite 110
Appleton, WV 54913-7862

Phone

(920) 739-5755

Fax

(920) 739-5151

NPI assigned

May 23, 2006

Organization subpart

No

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

Authorized official

Name

John Russell Lindstrom, MDNPI 1609821321

Title

MD/Owner

Phone

(920) 739-5755

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

Practitioners 1

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

• John Russell Lindstrom, MD

  • Orthopaedic Surgery Physician
  • Eau Claire, WI
  • NPI 1609821321
  NPD (past) Authorized official

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

{
    "created_epoch": "1148342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1831144567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2105 E ENTERPRISE AVE",
            "address_2": "SUITE 110",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549137862",
            "telephone_number": "920-739-5755",
            "fax_number": "920-739-5151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2105 E ENTERPRISE AVE",
            "address_2": "SUITE 110",
            "city": "APPLETON",
            "state": "WV",
            "postal_code": "549137862",
            "telephone_number": "920-739-5755",
            "fax_number": "920-739-5151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LINDSTROM ORTHOPEDIC CLINIC, SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LINDSTROM",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "RUSSELL",
        "authorized_official_title_or_position": "MD/OWNER",
        "authorized_official_telephone_number": "920-739-5755",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery",
            "state": "WI",
            "license": "22441",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID DME",
            "identifier": "41708100",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30283000",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.