Organization Active NPI

Orthopaedic Specialists, S.C.

  • Orthopaedic Surgery Physician
  • Neenah, WI
National Provider Identifier
1871645333
Registry record updated Jun 10, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
ORTHOPAEDIC SPECIALISTS, S.C.
Practice address
1516 S Commercial St
Neenah, WI 54956-4802
Phone
(920) 725-0077
Fax
(920) 725-6535
NPI assigned
Jan 17, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2009

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

Authorized official

Name
Ms. Diane Marie Boecker
Title
Office Manager
Phone
(920) 725-0077

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207X00000X Primary
Durable Medical Equipment & Medical Supplies 332B00000X 21334200 WI

Addresses

Primary practice location

1516 S Commercial St
Neenah, WI 54956-4802

Mailing address

1516 S Commercial St
Neenah, WI 54956-4802
Phone (920) 725-0077

Other identifiers 1

IdentifierTypeStateIssuer
21334200MedicaidWI

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1168992000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1244592000000",
    "number": "1871645333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1516 S COMMERCIAL ST",
            "city": "NEENAH",
            "state": "WI",
            "postal_code": "549564802",
            "telephone_number": "920-725-0077",
            "fax_number": "920-725-6535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1516 S COMMERCIAL ST",
            "city": "NEENAH",
            "state": "WI",
            "postal_code": "549564802",
            "telephone_number": "920-725-0077",
            "fax_number": "920-725-6535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORTHOPAEDIC SPECIALISTS, S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-17",
        "last_updated": "2009-06-10",
        "status": "A",
        "authorized_official_last_name": "BOECKER",
        "authorized_official_first_name": "DIANE",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "920-725-0077",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "WI",
            "license": "21334200",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "21334200",
            "state": "WI"
        }
    ],
    "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 Jun 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.