TERRY J DIETRICH (NPI# 1245274141) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245274141 |
| Entity Type | Individual |
| Full Name | TERRY J DIETRICH |
| Credential | MD |
| Practice Address |
1405 Mill St New London WI 54961-2155 |
| Mailing Address |
Po Box 8003 Appleton WI 54912-8003 |
| Practice Telephone | 9208315050 |
| Mailing Telephone | 9209963298 |
| Mailing Fax Number | 9207385787 |
| Enumeration Date | 2006-06-15 |
| Last Update Date | 2011-11-23 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207X00000X | Orthopaedic Surgery | 49333-020 | WI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | MEDICARE PTAN | 450030720 | 01 |
| Street Address |
1405 MILL ST |
| City | NEW LONDON |
| State | WI |
| Zip Code | 54961-2155 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598752057 | Hiep T Poppy | Physical Therapy Assistant | 1405 Mill St, New London, WI 54961-2155 | 2005-09-30 |
| 1952918328 | Emily Becher | Physical Therapist | 1405 Mill St, New London, WI 54961-2155 | 2020-09-29 |
| 1699232132 | Alyssa Wentworth | Physician Assistant | 1405 Mill St, New London, WI 54961-2155 | 2019-02-20 |
| 1609390855 | Leah M Lemke | Physician Assistant | 1405 Mill St, New London, WI 54961-2155 | 2017-07-31 |
| 1548783228 | Kelsey Mae Abendroth | Physical Therapist | 1405 Mill St, New London, WI 54961-2155 | 2017-07-25 |
| 1609397280 | Mayka L Rambo | Registered Nurse | 1405 Mill St, New London, WI 54961-2155 | 2017-07-04 |
| 1275087207 | Ryan Wagner | Emergency Medicine | 1405 Mill St, New London, WI 54961-2155 | 2016-08-08 |
| 1679932750 | Kristin M Roesler | Nurse Practitioner | 1405 Mill St, New London, WI 54961-2155 | 2016-02-17 |
| 1740675040 | Bryan Kent Hendrickson | Family Medicine | 1405 Mill St, New London, WI 54961-2155 | 2015-04-02 |
| 1972928463 | New London Family Medical Center Inc | Non-Pharmacy Dispensing Site | 1405 Mill St, New London, WI 54961-2155 | 2014-02-20 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407406408 | Cheryl Schneider | Technician | L 56 Northgate Estates, New London, WI 54961 | 2019-09-12 |
| 1861634719 | Rebecca L Kramer | Counselor | 315 Burton St, New London, WI 54961 | 2009-03-24 |
| 1598913501 | Marsha Ann Nytes | Licensed Practical Nurse | E8222 Weyawega Rd, New London, WI 54961 | 2008-09-03 |
| 1659585172 | Amanda L. Beck | Physical Therapy Assistant | 400 E. 4th Street, Manawa, WI 54961 | 2007-05-10 |
| 1366599433 | Griebenow Eyecare, S.c. | Optometrist | 105 Northridge Drive, New London, WI 54961 | 2007-01-04 |
| 1740822055 | Lauren Mae Flunker | Social Worker | E7475 Rawhide Rd, New London, WI 54961 | 2019-10-09 |
| 1063641249 | Forefront Dermatology, S.c. | Dermatology | 1620 N Shawano St, Suite C, New London, WI 54961 | 2009-07-08 |
| 1093982530 | Ascension Medical Group-fox Valley Wisconsin, Inc | Clinic/Center | 1420 Algoma St, New London, WI 54961 | 2008-05-14 |
| 1821263849 | Mark Alan Tegtmeier | Counselor | E7475 Rawhide Rd, New London, WI 54961 | 2008-04-30 |
| 1639282544 | Ascension Medical Group-fox Valley Wisconsin, Inc | Durable Medical Equipment & Medical Supplies | 1420 Algoma St, New London, WI 54961 | 2006-08-16 |
| Find all providers in zip 54961 | ||||
| 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 |
|---|---|---|---|---|
| 1447289004 | James C. Kelly | Orthopaedic Surgery | 59 Fair Harbour Pl, New London, CT 06320-4739 | 2006-07-03 |
| 1184692162 | Jeffrey Adam Miller | Orthopaedic Surgery | 6 Shaws Cv, Suite 101, New London, CT 06320-4969 | 2006-03-08 |
| 1275554222 | Shaws Cove Orthopaedics, LLC | Orthopaedic Surgery | 6 Shaws Cv, Suite 101, New London, CT 06320-4969 | 2006-07-22 |
| 1770512121 | James M. Murphy | Orthopaedic Surgery | 273 County Road, New London, NH 03257-0000 | 2006-06-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700486602 | Butler Orthopedics, LLP | Orthopaedic Surgery | 3237 S 16th St Ste 210, Milwaukee, WI 53215-4526 | 2020-10-29 |
| 1831729276 | Aspen Orthopedic and Rehabilation Specalist | Orthopaedic Surgery | 8907 S Howell Ave Ste 800, Oak Creek, WI 53154-4461 | 2020-01-24 |
| 1710520200 | Aspen Orthopedic and Rehabilation Specalist | Orthopaedic Surgery | 12555 W National Ave Ste 100, New Berlin, WI 53151-4061 | 2019-10-28 |
| 1477015931 | Multiple Care of Wi II, LLC | Orthopaedic Surgery | 8040 Excelsior Dr Ste 400, Madison, WI 53717-2915 | 2019-04-03 |
| 1508321209 | Ellen M Obrien | Orthopaedic Surgery | 5026 N Northwood Trce, Janesville, WI 53545-8990 | 2019-02-06 |
| 1487180238 | Ryan Scott Bailey | Orthopaedic Surgery | 7708 Milwaukee Ave, Wauwatosa, WI 53213-2209 | 2017-05-11 |
| 1932584927 | Anne Margarethe Ryan | Orthopaedic Surgery | 5940 Wild Rose Ln, Eau Claire, WI 54701-8783 | 2015-07-20 |
| 1003202631 | Bellin Memorial Hospital Inc | Orthopaedic Surgery | 218 So Hwy 141, Crivitz, WI 54114-1636 | 2015-04-10 |
| 1952728206 | Jacob R Seiler | Orthopaedic Surgery | 1205 West American Drive, Neenah, WI 54956-1405 | 2014-03-25 |
| 1770920472 | Jonathan Stone | Orthopaedic Surgery | 3111 W Rawson Ave Ste 200205, Franklin, WI 53132-9417 | 2013-06-04 |
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| City | NEW LONDON |
| Zip Code | 54961 |
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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.