ASCENSION MEDICAL GROUP-FOX VALLEY WISCONSIN, INC (NPI# 1306004692) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306004692 |
| Entity Type | Organization |
| Organization Name | ASCENSION MEDICAL GROUP-FOX VALLEY WISCONSIN, INC |
| Other Organization Name | ASCENSION MEDICAL GROUP |
| Practice Address |
708 W Ryan St Brillion WI 54110 |
| Mailing Address |
708 W Ryan St Brillion WI 54110-1045 |
| Practice Telephone | 9207565900 |
| Mailing Telephone | 9207382000 |
| Enumeration Date | 2008-05-23 |
| Last Update Date | 2020-08-10 |
| Authorized Official Name | TIMOTHY L MASEK (VP FINANCE) |
| Authorized Official Telephone | 4144653130 |
| 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 |
708 W RYAN ST |
| City | BRILLION |
| State | WI |
| Zip Code | 54110 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720274749 | Groskopp Chiropractic, Sc | Chiropractor | 708 W Ryan St, Brillion, WI 54110-1045 | 2007-09-24 |
| 1790953610 | Nathan Steven Cummings | Chiropractor | 708 W Ryan St, Brillion, WI 54110-1045 | 2008-02-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427691096 | Richelle L. Bruette | Technician | 306a Lavesta Ct., Brillion, WI 54110 | 2019-10-25 |
| 1659913614 | Emily M. Rataichek | Technician | 306a La Vesta Ct., Brillion, WI 54110 | 2019-10-11 |
| 1548457757 | Community Eyecare Inc | Optometrist | 950 W Ryan St, Suite A, Brillion, WI 54110 | 2007-10-02 |
| 1629120589 | Jeffery S Wierichs | Chiropractor | 114 N Main Street, Brillion, WI 54110 | 2007-01-18 |
| 1154478469 | Ascension Medical Group-fox Valley Wisconsin, Inc | Durable Medical Equipment & Medical Supplies | 708 W. Ryan St., Brillion, WI 54110 | 2007-01-05 |
| 1659377828 | Kanwar Arora | Internal Medicine | 133 Wisconsin Ave, Brillion, WI 54110 | 2005-06-22 |
| 1679729834 | Bel-regional Home Medical Inc | Eyewear Supplier (Equipment, not the service) | 964 W Ryan St, Suite E, Brillion, WI 54110 | 2008-08-07 |
| 1891963112 | Bellin Memorial Hospital Inc | Optometrist | 964 W Ryan St, Suite E, Brillion, WI 54110 | 2008-02-20 |
| 1104978055 | T.j. Kalies | Chiropractor | 114 N Main Street, Brillion, WI 54110 | 2007-01-18 |
| 1376821629 | Shopko Stores Operating Co LLC | Eyewear Supplier (Equipment, not the service) | 1010 W Ryan St, Brillion, WI 54110-0000 | 2011-08-03 |
| Find all providers in zip 54110 | ||||
| Taxonomy Code | 261QM1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Multi-Specialty |
| Definition to come... |
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| 1891106092 | Wisconsin Wellness Clinic | Clinic/Center | 280 Regency Ct, Suite 100, Brookfield, WI 53045-6165 | 2014-05-11 |
| 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 | ||||
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.