WISCONSIN PROSTHETICS & ORTHOTICS INC (NPI# 1023123098) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023123098 |
| Entity Type | Organization |
| Organization Name | WISCONSIN PROSTHETICS & ORTHOTICS INC |
| Other Organization Name | NOVACARE PROSTHETICS & ORTHOTICS |
| Practice Address |
1105 Wittmann Dr Menasha WI 54952-3607 |
| Mailing Address |
4714 Gettysburg Rd Mechanicsburg PA 17055-4325 |
| Practice Telephone | 9207256200 |
| Practice Fax Number | 9207256090 |
| Enumeration Date | 2006-08-20 |
| Last Update Date | 2017-03-08 |
| Authorized Official Name | MICHAEL E. TARVIN (VP & SECRETARY) |
| Authorized Official Telephone | 7179721100 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 335E00000X | Prosthetic/Orthotic Supplier | WI | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 41791800 | 05 |
| Other Name | Type Code |
|---|---|
| NovaCare Prosthetics & Orthotics | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346355252 | Wisconsin Prosthetics & Orthotics Inc | Prosthetic/Orthotic Supplier | 1344 N Taylor Dr, Sheboygan, WI 53081-3042 | 2006-08-20 |
| 1356456230 | Wisconsin Prosthetics & Orthotics Inc | Prosthetic/Orthotic Supplier | 4140 Harbor Town Ln, Ste 450, Manitowoc, WI 54220-5854 | 2006-08-20 |
| 1962409482 | Wisconsin Prosthetics & Orthotics Inc | Prosthetic/Orthotic Supplier | 1845 Velp Ave, Ste A, Green Bay, WI 54303-6594 | 2005-06-30 |
| Street Address |
1105 WITTMANN DR |
| City | MENASHA |
| State | WI |
| Zip Code | 54952-3607 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275776239 | Sharon Louise Crowe | Dental Hygienist | 1814 North Appleton Road, Menasha, WI 54952 | 2009-04-07 |
| 1003056110 | Nicole Marie Guyette | Dental Hygienist | 814 N. Appleton Road, Menasha, WI 54952 | 2009-03-02 |
| 1760627624 | Jan Charles Sarnecki | Orthopaedic Surgery | 1814 N. Appleton Road, Menasha, WI 54952 | 2008-12-08 |
| 1588828297 | Lesley R Lathrop | Registered Nurse | 1764 Oakridge Court, Menasha, WI 54952 | 2008-07-11 |
| 1699965137 | Lisa Randerson | Counselor | 1427c Province Terrace, Menasha, WI 54952 | 2007-07-31 |
| 1689748675 | Lisa Lynn Lang Riegel | Dentist | 1155 Wittman Drive, Menasha, WI 54952 | 2006-11-20 |
| 1164596144 | Robert Charles Lang | Dentist | 1155 Wittmann Drive, Menasha, WI 54952 | 2006-11-20 |
| 1366527947 | Karen Patricia Schmidt | Case Manager/Care Coordinator | 1810 Appleton Road, Menasha, WI 54952 | 2006-10-25 |
| 1376647388 | Goodwill Industries of North Central Wi | Counselor | 1800 Appleton Road, Menasha, WI 54952 | 2006-09-11 |
| 1386135614 | Leslie J Steckbauer | Counselor | 1095 Midway Rd, Menasha, WI 54952 | 2018-05-22 |
| Find all providers in zip 54952 | ||||
| Taxonomy Code | 335E00000X |
| Grouping | Suppliers |
| Classification | Prosthetic/Orthotic Supplier |
| An organization that provides prosthetic and orthotic care which may include, but is not limited to, patient evaluation, prosthesis or orthosis design, fabrication, fitting and modification to treat limb loss for purposes of restoring physiological function and/or cosmesis or to treat a neuromusculoskeletal disorder or acquired condition. |
| Notes: Source: American Board for Certification in Orthotics, Prosthetics, and Pedorthics, Inc. [7/1/2010: modified, 7/1/2013: modified] Additional Resources: American Board for Certification in Orthotics, Prosthetics and Pedorthics, Inc., www.abcop.org and Board of Certification/Accreditation, International, www.bocusa.org. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255932604 | Cassie Mae Mathis | Prosthetic/Orthotic Supplier | W1643 Greiner Rd, Freedom, WI 54130-7943 | 2020-11-03 |
| 1649648973 | Nordstrom | Prosthetic/Orthotic Supplier | 2424 N Mayfair Rd, Wauwatosa, WI 53226-1410 | 2015-09-03 |
| 1841698834 | Srt Prosthetics & Orthotics LLC | Prosthetic/Orthotic Supplier | 5220 S 27th St., Milwaukee, WI 53221 | 2014-12-08 |
| 1285908624 | Reichert Prosthetics & Orthotics, LLC | Prosthetic/Orthotic Supplier | 5027 Green Bay Rd Ste 124, Kenosha, WI 53144-1771 | 2012-03-02 |
| 1073807475 | Ralph's Shoes | Prosthetic/Orthotic Supplier | 336 Water St, Eau Claire, WI 54703-6132 | 2011-06-02 |
| 1982904769 | Better Balance LLC | Prosthetic/Orthotic Supplier | 2629 E Clairemont Ave, Eau Claire, WI 54701-6726 | 2010-10-27 |
| 1861718744 | Ripon Medical Center | Prosthetic/Orthotic Supplier | 165 W Huron St, Berlin, WI 54923-1590 | 2010-04-16 |
| 1225352172 | Hickok Rehab Services LLC | Prosthetic/Orthotic Supplier | 314 N Washington St, Thorp, WI 54771-9531 | 2010-03-22 |
| 1376866954 | Hickok Rehab Services LLC | Prosthetic/Orthotic Supplier | 831 Dallas St, Chetek, WI 54728-5811 | 2010-03-10 |
| 1124356993 | Natural Tresses LLC | Prosthetic/Orthotic Supplier | 2011 N Richmond St, Appleton, WI 54911-2771 | 2009-12-05 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.