Organization Active NPI

Orthopedic & Spine Therapy of Menasha, SC

  • Durable Medical Equipment & Medical Supplies
  • Kaukauna, WI
National Provider Identifier
1871665364
Registry record updated May 2, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
ORTHOPEDIC & SPINE THERAPY OF MENASHA, SC
Practice address
1901 Crooks Ave
Suite B
Kaukauna, WI 54130-3200
Phone
(920) 759-9075
Fax
(920) 759-9076
NPI assigned
Nov 14, 2006
Last updated
May 2, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 2, 2008

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

Authorized official

Name
Paul Steven Barnett, PT
Title
Owner and President
Phone
(920) 257-2000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X Primary

Addresses

Primary practice location

1901 Crooks Ave
Suite B
Kaukauna, WI 54130-3200

Mailing address

4000 N Providence Ave
Appleton, WI 54913-8018
Phone (920) 257-2000

Other identifiers 1

IdentifierTypeStateIssuer
41566000MedicaidWI

National Provider Directory

National Provider Directory

Locations

1901 Crooks Ave
Ste B
Kaukauna, WI 54130
Phone (920) 759-9075

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209686400000",
    "number": "1871665364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 N PROVIDENCE AVE",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549138018",
            "telephone_number": "920-257-2000",
            "fax_number": "920-257-2004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 CROOKS AVE",
            "address_2": "SUITE B",
            "city": "KAUKAUNA",
            "state": "WI",
            "postal_code": "541303200",
            "telephone_number": "920-759-9075",
            "fax_number": "920-759-9076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORTHOPEDIC & SPINE THERAPY OF MENASHA, SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-14",
        "last_updated": "2008-05-02",
        "status": "A",
        "authorized_official_last_name": "BARNETT",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "STEVEN",
        "authorized_official_title_or_position": "OWNER AND PRESIDENT",
        "authorized_official_telephone_number": "920-257-2000",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41566000",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kaukauna, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2008; 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.