SPORTS MEDICINE CENTER S C (NPI# 1093729055) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093729055 |
| Entity Type | Organization |
| Organization Name | SPORTS MEDICINE CENTER S C |
| Practice Address |
277 Altenhofen Dr Appleton WI 54913-8401 |
| Practice Telephone | 9209931643 |
| Practice Fax Number | 9209931645 |
| Mailing Telephone | 9209931643 |
| Mailing Fax Number | 9209931645 |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2009-01-20 |
| Authorized Official Name | DR. ETIENNE A MEJIA (PRESDIENT) |
| Authorized Official Telephone | 9209931643 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207X00000X | Orthopaedic Surgery | Allopathic & Osteopathic Physicians |
| Street Address |
277 ALTENHOFEN DR |
| City | APPLETON |
| State | WI |
| Zip Code | 54913-8401 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205866290 | Ronald W Schauland, Crna, LLC | Nurse Anesthetist, Certified Registered | 277 Altenhofen Dr, Appleton, WI 54913-8401 | 2006-07-04 |
| 1952559734 | Jeremy J Belter | Specialist/Technologist, Other | 277 Altenhofen Dr, Appleton, WI 54913-8401 | 2008-09-04 |
| 1982755583 | Richard Munster | Nurse Anesthetist, Certified Registered | 277 Altenhofen Dr, Appleton, WI 54913-8401 | 2007-01-12 |
| 1184648131 | Etienne A. Mejia | Orthopaedic Surgery | 277 Altenhofen Dr, Appleton, WI 54913-8401 | 2006-07-26 |
| 1134140122 | Arthroscopic Surgery Center, LLC | Clinic/Center | 277 Altenhofen Dr, Appleton, WI 54913-8401 | 2006-07-22 |
| 1821028812 | Ronald W Schauland | Nurse Anesthetist, Certified Registered | 277 Altenhofen Dr, Appleton, WI 54913-8401 | 2006-07-04 |
| 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 | 207X00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. American Osteopathic Board of Orthopaedic Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Orthopaedic Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881618833 | Timothy S Mologne | Orthopaedic Surgery | 2105 E Enterprise Ave # 111, Appleton, WI 54913 | 2006-07-26 |
| 1790754810 | Kenneth L Schaufelberger | Orthopaedic Surgery | 2105 E Enterprise Ave Ste 112, Appleton, WI 54913-7862 | 2006-03-14 |
| 1104826130 | Karen Fields | Orthopaedic Surgery | 2105 E. Enterprise Dr, Appleton, WI 54913 | 2005-08-01 |
| 1225035678 | Scott Preston Olvey | Orthopaedic Surgery | 2323 N Casaloma Dr, Appleton, WI 54913-8284 | 2005-06-30 |
| 1053314906 | Thomas G Hoeft | Orthopaedic Surgery | 1531 S Madison St, Appleton, WI 54915-1800 | 2005-05-24 |
| 1295132496 | Fox Valley Orthopaedic Surgeon's Association, Inc | Orthopaedic Surgery | 2105 E Enterprise Ave, Appleton, WI 54913-7862 | 2014-12-03 |
| 1356545396 | David N Conrad | Orthopaedic Surgery | 820 E Grant St, Thedacare Orthopedics Plus - Amc, Appleton, WI 54911-3483 | 2007-06-13 |
| 1790832665 | Nathan Lee Van Zeeland | Orthopaedic Surgery | 2323 N Casaloma Dr, Appleton, WI 54913-8284 | 2007-01-04 |
| 1770630592 | Matthew Butler | Orthopaedic Surgery | 2323 N Casaloma Dr, Appleton, WI 54913-8284 | 2007-01-04 |
| 1184648131 | Etienne A. Mejia | Orthopaedic Surgery | 277 Altenhofen Dr, Appleton, WI 54913-8401 | 2006-07-26 |
| Find all providers in APPLETON | ||||
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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.