Active NPI
New Surgical Associates SC
- Surgery Physician
- Green Bay, WI
National Provider Identifier
1891808671
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 44472 | Other | LICENSE SCOTT L RUGGLES | |
| 34387 | Other | PETER M FALK | |
| 35428 | Other | LICENSE JAMES M KEMMERLIN | |
| 39619 | Other | LICENSE PETER W DAVIS | |
| CI5843 | Other | WI | RAILROAD MEDICARE |
National Provider Directory
National Provider DirectoryLocations
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.
-
- Family Nurse Practitioner
- Green Bay, WI
- NPI 1841308681
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.