FAMILY & SPORTS ORTHOPAEDIC CENTER, LLC (NPI# 1467565978) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467565978 |
| Entity Type | Organization |
| Organization Name | FAMILY & SPORTS ORTHOPAEDIC CENTER, LLC |
| Practice Address |
118 W Maple Ave Beaver Dam WI 53916-2104 |
| Practice Telephone | 9203561000 |
| Practice Fax Number | 9203560719 |
| Mailing Telephone | 9203561000 |
| Mailing Fax Number | 9203560719 |
| Enumeration Date | 2006-08-17 |
| Last Update Date | 2011-03-02 |
| Authorized Official Name | DR. ROBERT A COE (MEMBER) |
| Authorized Official Telephone | 9203561000 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | 36330 | WI | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | PHYSICIANS PLUS | 2033322 | 01 |
| WI | 30082300 | 05 | |
| WI | DEAN | 15104 | 01 |
| WI | DEAN | 15909 | 01 |
| WI | PHYSICIANS PLUS | 2028274 | 01 |
| WI | 40349200 | 05 | |
| WI | 40452200 | 05 | |
| WI | PHYSICIANS PLUS | 1003837 | 01 |
| WI | PHYSICIANS PLUS | 1034219 | 01 |
| WI | WPS | 391796912 | 01 |
| WI | PHYSICIANS PLUS | 1002676 | 01 |
| WI | 32123200 | 05 | |
| WI | 36027400 | 05 | |
| WI | 43020200 | 05 | |
| WI | 30821700 | 05 | |
| WI | DEAN | 11801 | 01 |
| WI | DEAN | 13843 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841451622 | Family & Sports Orthopaedic Center, LLC | Orthopaedic Surgery | 1515 Park Ave, Columbus, WI 53925-1618 | 2008-06-24 |
| 1649430380 | Family & Sports Orthopaedic Center, LLC | Orthopaedic Surgery | 620 W Brown St, Waupun, WI 53963-1702 | 2008-06-16 |
| 1194984880 | Family & Sports Orthopaedic Center, LLC | Orthopaedic Surgery | 1511 Park Ave, Columbus, WI 53925-2401 | 2008-06-06 |
| Street Address |
118 W MAPLE AVE |
| City | BEAVER DAM |
| State | WI |
| Zip Code | 53916-2104 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588032767 | Holly Landry | Physical Therapist | 118 W Maple Ave, Beaver Dam, WI 53916-2104 | 2015-09-04 |
| 1093137416 | Prairie Ridge Health, Inc. | Surgery | 118 W Maple Ave, Beaver Dam, WI 53916-2104 | 2014-01-21 |
| 1336425016 | Dean Health Systems, Inc | Durable Medical Equipment & Medical Supplies | 118 W Maple Ave, Beaver Dam, WI 53916-2104 | 2011-10-26 |
| 1184933756 | Judy A Macdonald | Nurse Practitioner | 118 W Maple Ave, Beaver Dam, WI 53916-2104 | 2010-09-30 |
| 1508029174 | Andrew T Tratar | Physician Assistant | 118 W Maple Ave, Beaver Dam, WI 53916-2104 | 2008-07-03 |
| 1679633580 | Kristine Braker | Nurse Practitioner | 118 W Maple Ave, Beaver Dam, WI 53916-2104 | 2006-12-11 |
| 1912077140 | Thomas Carl Smedberg | Orthopaedic Surgery | 118 W Maple Ave, Beaver Dam, WI 53916-2104 | 2006-11-08 |
| 1932212461 | Robert A Coe | Specialist | 118 W Maple Ave, Beaver Dam, WI 53916-2104 | 2006-08-17 |
| 1366555815 | David C Barton | Specialist | 118 W Maple Ave, Beaver Dam, WI 53916-2104 | 2006-08-17 |
| 1508979972 | Micheal E Ceizyk | Physical Therapist | 118 W Maple Ave, Beaver Dam, WI 53916-2104 | 2006-08-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538718283 | Paulette Neibauer | Technician | N7262 Farwell Rd., Beaver Dam, WI 53916 | 2019-09-05 |
| 1902336597 | Tricounty Homecare Inc | In Home Supportive Care | 140 Corporate Dr Ste 2, Beaver Dam, WI 53916 | 2017-06-15 |
| 1528502754 | Jessica Marie Blatz | Counselor | 809 Park Aveune, Beaver Dam, WI 53916 | 2016-12-07 |
| 1376090886 | Beaver Dam Hearing Care, LLC | Hearing Aid Equipment | 705 University Ave, Suite 170, Beaver Dam, WI 53916 | 2016-09-01 |
| 1275902546 | Beaver Dam Community Hospitals Inc | Pharmacy | 705 S University Ave Ste 180, Beaver Dam, WI 53916 | 2015-09-17 |
| 1609242825 | Tami Joe Delisle | Counselor | 207 North Spring Street, Beaver Dam, WI 53916 | 2015-08-12 |
| 1366833394 | Beaver Dam Community Hospitals, Inc | Surgery | 705 S University Ave Ste 350, Beaver Dam, WI 53916 | 2015-02-12 |
| 1326471608 | Raquel Rodriguez-guzman | Pharmacist | 205 La Crosse Street, Beaver Dam, WI 53916 | 2013-08-09 |
| 1558608828 | Mary Y Kunz | Licensed Practical Nurse | 6550 N Highway 151 Lot 63, Beaverdam, WI 53916 | 2013-01-07 |
| 1881938454 | Brock Holden Slinger | Physical Therapist | 205 Monroe St. #13, Beaver Dam, WI 53916 | 2012-11-20 |
| Find all providers in zip 53916 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669803268 | Maria Derksen | Specialist | 33 University Ave, Beaver Dam, WI 53916-8847 | 2013-12-06 |
| 1558301499 | Karen Michele Brooks | Specialist | 1217 N Main St, Beaver Dam, KY 42320-8955 | 2006-06-08 |
| 1740704089 | Beaver Dam Community Hospitals Inc | Specialist | 705 S University Ave Ste 150, Beaver Dam, WI 53916 | 2017-07-28 |
| 1841476678 | Kimberly J Bivens | Specialist | 1211 N Main St, Beaver Dam, KY 42320-8955 | 2008-01-10 |
| 1992998884 | Tara L. Passow Md Inc | Specialist | 700 Hillcrest Ct, Beaver Dam, WI 53916-2418 | 2007-08-23 |
| 1639294481 | Elite Physical Therapy & Fitness, Psc | Specialist | 1217 N Main St, Beaver Dam, KY 42320-8955 | 2007-03-20 |
| 1124128228 | Lynn R Swiggum | Specialist | 705 S University Ave, Suite 150, Beaver Dam, WI 53916-3053 | 2006-09-25 |
| 1932212461 | Robert A Coe | Specialist | 118 W Maple Ave, Beaver Dam, WI 53916-2104 | 2006-08-17 |
| 1366555815 | David C Barton | Specialist | 118 W Maple Ave, Beaver Dam, WI 53916-2104 | 2006-08-17 |
| 1689607087 | Integrity Urologic, Sc | Specialist | 707 S University Ave, Beaver Dam, WI 53916-3027 | 2006-07-08 |
| Find all providers in BEAVER DAM | ||||
| City | BEAVER DAM |
| Zip Code | 53916 |
Please comment or provide details below to improve the information on FAMILY & SPORTS ORTHOPAEDIC CENTER, 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.