Organization Active NPI

New Surgical Associates SC

  • Surgery Physician
  • Green Bay, WI
National Provider Identifier
1891808671
Registry record updated Apr 24, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
NEW SURGICAL ASSOCIATES SC
Practice address
670 Cormier Rd
Green Bay, WI 54304-4824
Phone
(920) 494-9685
Fax
(920) 494-8417
NPI assigned
Aug 16, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2017

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

Authorized official

Name
Cheryl L Herlache
Title
Accounts Receivable Representative
Phone
(920) 497-7678

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208600000X Primary

Addresses

Primary practice location

670 Cormier Rd
Green Bay, WI 54304-4824

Mailing address

670 Cormier Road
Green Bay, WI 54304
Phone (920) 494-9685

Other identifiers 5

IdentifierTypeStateIssuer
44472OtherLICENSE SCOTT L RUGGLES
34387OtherPETER M FALK
35428OtherLICENSE JAMES M KEMMERLIN
39619OtherLICENSE PETER W DAVIS
CI5843OtherWIRAILROAD MEDICARE

National Provider Directory

National Provider Directory

Locations

2353 S Ridge Rd
Ste 3
Green Bay, WI 54304
Phone (920) 494-9685

203 Smith Ave
Oconto, WI 54153
Phone (877) 336-5629

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1155686400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1492992000000",
    "number": "1891808671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "670 CORMIER ROAD",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "54304",
            "telephone_number": "920-494-9685",
            "fax_number": "920-494-8417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "670 CORMIER RD",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543044824",
            "telephone_number": "920-494-9685",
            "fax_number": "920-494-8417"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW SURGICAL ASSOCIATES SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-16",
        "last_updated": "2017-04-24",
        "status": "A",
        "authorized_official_last_name": "HERLACHE",
        "authorized_official_first_name": "CHERYL",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "ACCOUNTS RECEIVABLE REPRESENTATIVE",
        "authorized_official_telephone_number": "920-497-7678"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE SCOTT L RUGGLES",
            "identifier": "44472",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PETER M FALK",
            "identifier": "34387",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE JAMES M KEMMERLIN",
            "identifier": "35428",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE PETER W DAVIS",
            "identifier": "39619",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CI5843",
            "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 24, 2017; 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.