ASCENSION MEDICAL GROUP-FOX VALLEY WISCONSIN, INC (NPI# 1043478324) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043478324 |
| Entity Type | Organization |
| Organization Name | ASCENSION MEDICAL GROUP-FOX VALLEY WISCONSIN, INC |
| Other Organization Name | ASCENSION MEDICAL GROUP |
| Practice Address |
200 Patriot Dr Little Chute WI 54140 |
| Mailing Address |
200 Patriot Dr Little Chute WI 54140-1184 |
| Practice Telephone | 9206872800 |
| Mailing Telephone | 9207382000 |
| Enumeration Date | 2008-05-23 |
| Last Update Date | 2020-08-14 |
| Authorized Official Name | TIMOTHY L MASEK (VP-FINANCE) |
| Authorized Official Telephone | 4144653000 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM1300X |
Clinic/Center Specialization: Multi-Specialty |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 32752000 | 05 |
| Other Name | Type Code |
|---|---|
| Ascension Medical Group | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437317708 | Ascension Medical Group-fox Valley Wisconsin, Inc | Clinic/Center | 1160 Service Rd, Kiel, WI 53042 | 2008-05-23 |
| 1679731954 | Ascension Medical Group-fox Valley Wisconsin, Inc | Clinic/Center | 1128 E Parkway Ave, Oshkosh, WI 54901 | 2008-05-23 |
| 1669639142 | Ascension Medical Group-fox Valley Wisconsin, Inc | Clinic/Center | N9642 County Rd N, Appleton, WI 54915 | 2008-05-21 |
| 1265699748 | Ascension Medical Group-fox Valley Wisconsin, Inc | Clinic/Center | 1531 S Madison St Fl 4, Appleton, WI 54915 | 2008-05-21 |
| 1073770558 | Ascension Medical Group-fox Valley Wisconsin, Inc | Clinic/Center | 1531 S Madison St Ste 580, Appleton, WI 54915 | 2008-05-21 |
| 1639226962 | Ascension Medical Group-fox Valley Wisconsin, Inc | Durable Medical Equipment & Medical Supplies | N9642 County N, Appleton, WI 54915 | 2007-01-05 |
| 1154478469 | Ascension Medical Group-fox Valley Wisconsin, Inc | Durable Medical Equipment & Medical Supplies | 708 W. Ryan St., Brillion, WI 54110 | 2007-01-05 |
| 1780781096 | Ascension Medical Group-fox Valley Wisconsin, Inc | Durable Medical Equipment & Medical Supplies | 632 Fremont St., Kiel, WI 53042 | 2006-09-20 |
| 1073970984 | Ascension Medical Group-fox Valley Wisconsin, Inc | Clinic/Center | 1610 Hoover St, New Holstein, WI 53061 | 2016-01-22 |
| 1275963845 | Ascension Medical Group-fox Valley Wisconsin, Inc | Clinic/Center | 1506 S Oneida St, Appleton, WI 54915 | 2013-11-19 |
| Street Address |
200 PATRIOT DR |
| City | LITTLE CHUTE |
| State | WI |
| Zip Code | 54140 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093709651 | Jack R Meyer | Family Medicine | 200 Patriot Dr, Little Chute, WI 54140-1184 | 2005-09-09 |
| 1144731498 | Paul R Garcia | Family Medicine | 200 Patriot Dr, Little Chute, WI 54140 | 2017-10-13 |
| 1750520383 | Brieanna M Haroldson | Physician Assistant | 200 Patriot Dr, Little Chute, WI 54140-1184 | 2009-02-04 |
| 1245335165 | Ascension Medical Group-fox Valley Wisconsin, Inc | Durable Medical Equipment & Medical Supplies | 200 Patriot Dr, Little Chute, WI 54140 | 2006-09-14 |
| 1144277625 | Meena P Vir | Family Medicine | 200 Patriot Dr, Little Chute, WI 54140-1184 | 2006-05-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841335536 | Dann Norbert Pynenberg | Dentist | 607 Wilson Street, Little Chute, WI 54140 | 2007-02-20 |
| 1043207707 | Peter J Kordiyak | Physician Assistant | 200 Patriot Drive, Little Chute, WI 54140 | 2005-09-28 |
| 1538451307 | Jessica L Peterson | Family Medicine | 200 Patriot Drive, Little Chute, WI 54140 | 2011-05-11 |
| 1164550208 | Ebben & Pynenberg Dds Sc | Dentist | 607 Wilson St, Little Chute, WI 54140 | 2007-03-01 |
| 1134264922 | Michael Charles Ebben | Dentist | 607 Wilson St, Little Chute, WI 54140 | 2007-02-20 |
| 1366809758 | Katie Woldt | Registered Nurse | 1502 Biscayne Dr, Little Chute, WI 54140-1006 | 2016-01-15 |
| 1770878233 | Isabelle Holdridge | Registered Nurse | 1030f W Elm Dr Apt 16, Little Chute, WI 54140-1099 | 2011-06-13 |
| 1740716224 | Lisa Hartjes | Registered Nurse | 332 Cherry Ln, Little Chute, WI 54140-1107 | 2017-05-03 |
| 1366717068 | Harriette Xaveria Janssen | Respiratory Therapist, Registered | 1809 Roosevelt St, Little Chute, WI 54140-1234 | 2012-03-13 |
| 1205210499 | Erika Vandenberg | Speech-Language Pathologist | 1530 Freedom Rd, Little Chute, WI 54140-1315 | 2015-07-17 |
| Find all providers in zip 54140 | ||||
| Taxonomy Code | 261QM1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Multi-Specialty |
| Definition to come... |
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| 1437317708 | Ascension Medical Group-fox Valley Wisconsin, Inc | Clinic/Center | 1160 Service Rd, Kiel, WI 53042 | 2008-05-23 |
| 1679731954 | Ascension Medical Group-fox Valley Wisconsin, Inc | Clinic/Center | 1128 E Parkway Ave, Oshkosh, WI 54901 | 2008-05-23 |
| 1669639142 | Ascension Medical Group-fox Valley Wisconsin, Inc | Clinic/Center | N9642 County Rd N, Appleton, WI 54915 | 2008-05-21 |
| Find all providers with the same taxonomy | ||||
| City | LITTLE CHUTE |
| Zip Code | 54140 |
Please comment or provide details below to improve the information on ASCENSION MEDICAL GROUP-FOX VALLEY WISCONSIN, INC.
| 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.