FVOSA SURGICAL PARTNERS, LLC (NPI# 1043254162) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043254162 |
| Entity Type | Organization |
| Organization Name | FVOSA SURGICAL PARTNERS, LLC |
| Other Organization Name | ORTHOPEDIC & SPORTS SURGERY CENTER |
| Practice Address |
2105 E. Enterprise Ave. Suite 101 Appleton WI 54913 |
| Practice Telephone | 9205601100 |
| Practice Fax Number | 9205601112 |
| Mailing Telephone | 9205601100 |
| Mailing Fax Number | 9205601112 |
| Enumeration Date | 2006-06-16 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. J. DAVID KUPLIC (PRESIDENT OF FVOSA) |
| Authorized Official Telephone | 920-731-6611 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QA1903X |
Clinic/Center Specialization: Ambulatory Surgical |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Orthopedic & Sports Surgery Center | Doing Business As Name - Organization |
| Street Address |
2105 E. ENTERPRISE AVE. SUITE 101 |
| City | APPLETON |
| State | WI |
| Zip Code | 54913 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467702241 | Kara L Brochtrup | Nurse Practitioner | 2105 E. Enterprise Ave., Suite 111, Appleton, WI 54913-7862 | 2012-09-19 |
| 1629218417 | Nicole E. Juedes | Specialist/Technologist, Other | 2105 E. Enterprise Ave., Suite 111, Appleton, WI 54913-7862 | 2009-03-06 |
| 1053578682 | Todd A Derksen | Podiatrist | 2105 E. Enterprise Ave., Suite 111, Appleton, WI 54913-7862 | 2008-05-21 |
| 1811179344 | Eric R. Bowen | Nurse Practitioner | 2105 E. Enterprise Ave., Suite 111, Appleton, WI 54913-7862 | 2007-11-27 |
| 1720023724 | Great Lakes Orthotics & Prosthetics Inc. | Prosthetic/Orthotic Supplier | 2105 E. Enterprise Ave., Suite 114, Appleton, WI 54913 | 2006-06-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457994584 | Pamela J Andersen | Music Therapist | 245 N. Metro Drive, Appleton, WI 54913 | 2019-10-22 |
| 1396387510 | Nancy Sibley | Technician | N4423 County Road Ee, Appleton, WI 54913 | 2019-10-09 |
| 1659872240 | Meijer Stores Limited Partnership | Durable Medical Equipment & Medical Supplies | 3801 N. Richmond Street, Grand Chute, WI 54913 | 2018-02-28 |
| 1780116244 | Alison Pelger | Physician Assistant | 3916 North Intertech Court, Appleton, WI 54913 | 2017-04-03 |
| 1316311905 | Lucy Bouressa | Specialist/Technologist | 2105 E. Enterprise Ave, 113, Appleton, WI 54913 | 2015-11-19 |
| 1992189989 | Brittany Reinke | Physical Therapist | Walking and Wheeling, LLC, W4652 Glenn Street, Appleton, WI 54913 | 2015-07-20 |
| 1902280092 | Costco Wholesale Corporation | Pharmacy | 5401 W Integrity Way, Grand Chute, WI 54913 | 2015-07-17 |
| 1942646849 | Richard Anthony Mauthe | Pharmacist | 5401 W. Integrity Way, Neenah, WI 54913 | 2013-05-17 |
| 1750622163 | Tonya Janelle Wilderman | Pharmacist | 1400 N Mccarthy Rd, Apt 2, Grand Chute, WI 54913 | 2013-03-10 |
| 1295938777 | Jenna Marie Kadlec | Physical Therapist | 3916 N. Intertech Court, Appleton, WI 54913 | 2007-06-11 |
| Find all providers in zip 54913 | ||||
| Taxonomy Code | 261QA1903X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Ambulatory Surgical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083242325 | Appleton Surgical Center LLC | Clinic/Center | 1616 N Casaloma Dr # 200, Appleton, WI 54913-8245 | 2020-03-31 |
| 1548502008 | Pain Centers of Wisconsin - Appleton, LLC | Clinic/Center | 1616 N Casaloma Dr, Appleton, WI 54913-8245 | 2013-03-22 |
| 1245297662 | Woodland Surgery Center LLC | Clinic/Center | 2325 N Casaloma Dr, Appleton, WI 54913-8284 | 2006-04-28 |
| 1275513806 | Pinnacle Cataract and Laser Institute LLC | Clinic/Center | 4648 W Spencer St, Appleton, WI 54914-9106 | 2006-01-19 |
| 1851623961 | Alexander Eye Surgery Center, LLC | Clinic/Center | 250 N Metro Dr, Appleton, WI 54913-8571 | 2010-02-01 |
| 1184837353 | North Shore Foot & Ankle Surgery Center, LLC | Clinic/Center | 2005 S Lake Park Rd, Appleton, WI 54915-4155 | 2007-05-07 |
| 1134140122 | Arthroscopic Surgery Center, LLC | Clinic/Center | 277 Altenhofen Dr, Appleton, WI 54913-8401 | 2006-07-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073113841 | Spine Solutions of West Bend LLC | Clinic/Center | 1000 Gateway Ct Ste 200, West Bend, WI 53095-8541 | 2020-10-29 |
| 1205454626 | Eye Surgery Center of Wisconsin, LLC | Clinic/Center | 10148 S 27th St, Oak Creek, WI 51354 | 2020-07-13 |
| 1164056974 | Orthopedic Surgery Center of The Fox Valley LLC | Clinic/Center | 1205 W. American Drive, Neenah, WI 54596-5459 | 2020-03-02 |
| 1013548833 | Ascension Wisconsin Surgery Center-mount Pleasant LLC | Clinic/Center | 10180 Washington Ave Ste 200, Mount Pleasant, WI 53177-1604 | 2020-01-30 |
| 1497393516 | Aurora Surgery Centers, LLC | Clinic/Center | 12500 Aurora Drive, Pleasant Prairie, WI 53158 | 2019-12-19 |
| 1275178444 | Kenosha Digestive Health Center LLC | Clinic/Center | 8220 75th St, Kenosha, WI 53142-7637 | 2019-11-12 |
| 1851887715 | Southern Lakes Endoscopy LLC | Clinic/Center | 240 Maple Ave Ste 2220, Mukwonago, WI 53149-8475 | 2018-07-03 |
| 1447768411 | Wisconsin Institute of Surgical Excellence LLC | Clinic/Center | 1265 W American Dr Ste 200, Neenah, WI 54956 | 2018-01-12 |
| 1629518006 | Great Lakes Surgery LLC | Clinic/Center | 6123 Green Bay Rd Ste 101, Kenosha, WI 53142-2927 | 2017-03-03 |
| 1447799580 | Geneva Surgical Suites, LLC | Clinic/Center | 119 Elizabeth Lane, Genoa City, WI 53128-2124 | 2017-02-22 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on FVOSA SURGICAL PARTNERS, LLC.
| 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.