WISCONSIN PROSTHETICS & ORTHOTICS INC (NPI# 1962409482) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962409482 |
| Entity Type | Organization |
| Organization Name | WISCONSIN PROSTHETICS & ORTHOTICS INC |
| Other Organization Name | NOVACARE PROSTHETICS & ORTHOTICS |
| Practice Address |
1845 Velp Ave Ste A Green Bay WI 54303-6594 |
| Mailing Address |
4714 Gettysburg Rd Mechanicsburg PA 17055-4325 |
| Practice Telephone | 9204353537 |
| Practice Fax Number | 9204353545 |
| Enumeration Date | 2005-06-30 |
| Last Update Date | 2017-03-08 |
| Authorized Official Name | MICHAEL E. TARVIN (VP & SECRETARY) |
| Authorized Official Telephone | 7179721100 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 335E00000X | Prosthetic/Orthotic Supplier | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 41791900 | 05 |
| Other Name | Type Code |
|---|---|
| NovaCare Prosthetics & Orthotics | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023123098 | Wisconsin Prosthetics & Orthotics Inc | Prosthetic/Orthotic Supplier | 1105 Wittmann Dr, Menasha, WI 54952-3607 | 2006-08-20 |
| 1346355252 | Wisconsin Prosthetics & Orthotics Inc | Prosthetic/Orthotic Supplier | 1344 N Taylor Dr, Sheboygan, WI 53081-3042 | 2006-08-20 |
| 1356456230 | Wisconsin Prosthetics & Orthotics Inc | Prosthetic/Orthotic Supplier | 4140 Harbor Town Ln, Ste 450, Manitowoc, WI 54220-5854 | 2006-08-20 |
| Street Address |
1845 VELP AVE STE A |
| City | GREEN BAY |
| State | WI |
| Zip Code | 54303-6594 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255795845 | Saha Cares | Home Health | 1845 Velp Ave, Suite F, Green Bay, WI 54303-6594 | 2016-04-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952921033 | Ashley Marie Vandermoss | Social Worker | 1601 W Mason Street, Green Bay, WI 54303 | 2020-04-20 |
| 1598307423 | Jean Marie Castaneda | Case Manager/Care Coordinator | 2517 N. Court, Green Bay, WI 54303 | 2019-10-11 |
| 1215579552 | Integrated Treatment Centers, LLC | Clinic/Center | 2311 W Mason Street, Green Bay, WI 54303 | 2019-10-08 |
| 1003460551 | Affordable Dentures & Implants - Green Bay, S.c. | Dentist | 1800-c W. Mason Street, Green Bay, WI 54303 | 2019-08-01 |
| 1164940375 | Kaeley Rae Blaney | Student in an Organized Health Care Education/Training Program | 2088 Memorial Drive #208, Green Bay, WI 54303 | 2017-09-07 |
| 1518498047 | Treatment Providers LLC | Clinic/Center | 2731 N Packerland Dr Ste A, Green Bay, WI 54303 | 2017-03-26 |
| 1851840565 | Back To Balance Chiropractic, LLC | Chiropractor | 110 Packerland Drive, Suite B, Green Bay, WI 54303 | 2016-09-23 |
| 1710361001 | Matthew Lemay | Acupuncturist | 727 E Walnut, Suite B2, Green Bay, WI 54303 | 2015-07-16 |
| 1144600149 | Carrie Jean Banaszak | Counselor | 1039 Mason Street, Green Bay, WI 54303 | 2015-06-04 |
| 1174921993 | Kensey Meyer | Occupational Therapy Assistant | 1555 Dousman Road, Seymour, WI 54303 | 2014-12-10 |
| Find all providers in zip 54303 | ||||
| Taxonomy Code | 335E00000X |
| Grouping | Suppliers |
| Classification | Prosthetic/Orthotic Supplier |
| An organization that provides prosthetic and orthotic care which may include, but is not limited to, patient evaluation, prosthesis or orthosis design, fabrication, fitting and modification to treat limb loss for purposes of restoring physiological function and/or cosmesis or to treat a neuromusculoskeletal disorder or acquired condition. |
| Notes: Source: American Board for Certification in Orthotics, Prosthetics, and Pedorthics, Inc. [7/1/2010: modified, 7/1/2013: modified] Additional Resources: American Board for Certification in Orthotics, Prosthetics and Pedorthics, Inc., www.abcop.org and Board of Certification/Accreditation, International, www.bocusa.org. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356441950 | Vagabond Shoes, Inc. | Prosthetic/Orthotic Supplier | 635 Bay Park Sq, Green Bay, WI 54304-5101 | 2006-09-23 |
| 1962893842 | Align Clinic, LLC | Prosthetic/Orthotic Supplier | 445 Cardinal Ln Ste 110, Green Bay, WI 54313-9587 | 2015-02-12 |
| 1477892412 | Stacey M Nellen-kolze | Prosthetic/Orthotic Supplier | 2031 S Webster Ave, Suite B, Green Bay, WI 54301-2257 | 2013-02-12 |
| 1013289743 | New Hair, LLC | Prosthetic/Orthotic Supplier | 2031 S Webster Ave, Suite B, Green Bay, WI 54301-2257 | 2012-01-26 |
| 1720397490 | Access Prosthetics LLC | Prosthetic/Orthotic Supplier | 2020 Riverside Dr, 3rd Floor, Green Bay, WI 54301-2300 | 2010-09-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255932604 | Cassie Mae Mathis | Prosthetic/Orthotic Supplier | W1643 Greiner Rd, Freedom, WI 54130-7943 | 2020-11-03 |
| 1649648973 | Nordstrom | Prosthetic/Orthotic Supplier | 2424 N Mayfair Rd, Wauwatosa, WI 53226-1410 | 2015-09-03 |
| 1841698834 | Srt Prosthetics & Orthotics LLC | Prosthetic/Orthotic Supplier | 5220 S 27th St., Milwaukee, WI 53221 | 2014-12-08 |
| 1285908624 | Reichert Prosthetics & Orthotics, LLC | Prosthetic/Orthotic Supplier | 5027 Green Bay Rd Ste 124, Kenosha, WI 53144-1771 | 2012-03-02 |
| 1073807475 | Ralph's Shoes | Prosthetic/Orthotic Supplier | 336 Water St, Eau Claire, WI 54703-6132 | 2011-06-02 |
| 1982904769 | Better Balance LLC | Prosthetic/Orthotic Supplier | 2629 E Clairemont Ave, Eau Claire, WI 54701-6726 | 2010-10-27 |
| 1861718744 | Ripon Medical Center | Prosthetic/Orthotic Supplier | 165 W Huron St, Berlin, WI 54923-1590 | 2010-04-16 |
| 1225352172 | Hickok Rehab Services LLC | Prosthetic/Orthotic Supplier | 314 N Washington St, Thorp, WI 54771-9531 | 2010-03-22 |
| 1376866954 | Hickok Rehab Services LLC | Prosthetic/Orthotic Supplier | 831 Dallas St, Chetek, WI 54728-5811 | 2010-03-10 |
| 1124356993 | Natural Tresses LLC | Prosthetic/Orthotic Supplier | 2011 N Richmond St, Appleton, WI 54911-2771 | 2009-12-05 |
| Find all providers with the same taxonomy | ||||
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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.