DR. TIMOTHY S MOLOGNE (NPI# 1881618833) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1881618833 |
Entity Type | Individual |
Full Name | DR. TIMOTHY S MOLOGNE |
Credential | M.D. |
Practice Address |
2105 E Enterprise Ave # 111 Appleton WI 54913 |
Mailing Address |
2105 E Enterprise Ave # 111 Appleton WI 54913-7862 |
Practice Telephone | 9207316611 |
Practice Fax Number | 9207316732 |
Mailing Telephone | 9207316611 |
Mailing Fax Number | 9207316732 |
Enumeration Date | 2006-07-26 |
Last Update Date | 2019-01-14 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgery | 46236 | WI | Allopathic & Osteopathic Physicians |
Y | 207XX0005X |
Orthopaedic Surgery Specialization: Sports Medicine |
46236 | WI | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
WI | BC/BS | 391821816017 | 01 |
Address | Telephone Number | Fax Number |
---|---|---|
277 Altenhofen Dr, Appleton, WI 549138401 | 9209931643 | 9209931645 |
Street Address |
2105 E ENTERPRISE AVE # 111 |
City | APPLETON |
State | WI |
Zip Code | 54913 |
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 | 207XX0005X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Orthopaedic Surgery |
Specialization | Sports Medicine |
An orthopaedic surgeon trained in sports medicine provides appropriate care for all structures of the musculoskeletal system directly affected by participation in sporting activity. This specialist is proficient in areas including conditioning, training and fitness, athletic performance and the impact of dietary supplements, pharmaceuticals, and nutrition on performance and health, coordination of care within the team setting utilizing other health care professionals, field evaluation and management, soft tissue biomechanics and injury healing and repair. Knowledge and understanding of the principles and techniques of rehabilitation, athletic equipment and orthotic devices enables the specialist to prevent and manage athletic injuries. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton changed, source changed] Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. ACGME Accredited Program Requirements: 1 year GME in the specialty + 5 years of Orthopaedic Surgery for a total of 6 years |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1144464199 | Lyall Carlton Stilp II | Orthopaedic Surgery | 2133 Willow Ln, Oshkosh, WI 54902-9121 | 2009-04-21 |
1992953921 | William David Jones | Orthopaedic Surgery | 1554 River Pines Dr, Green Bay, WI 54311-5648 | 2008-09-03 |
1588639256 | Albert J Cecchini | Orthopaedic Surgery | 3119 Woodman Dr, Altoona, WI 54720-2668 | 2006-02-17 |
1811992886 | Tamara A Scerpella | Orthopaedic Surgery | 621 Science Dr, Madison, WI 53711-1074 | 2005-06-16 |
1538716725 | Jessica Lynn Flood | Orthopaedic Surgery | 4602 Eastpark Blvd, Madison, WI 53718-2002 | 2019-08-22 |
1154883593 | Kristin K. Lietzau | Orthopaedic Surgery | Beloit Clinic, 1905 E. Huebbe Parkway, Beloit, WI 53511-1842 | 2019-04-04 |
1154839140 | Sandra Koester | Orthopaedic Surgery | 1111 Delafield St, Waukesha, WI 53188 | 2018-01-12 |
1750736120 | Orthopaedic Centers of Wisconsin, S.c. | Orthopaedic Surgery | 500 Vincent St, Stevens Point, WI 54481-1842 | 2016-05-04 |
1740549773 | Community Health Network Inc | Orthopaedic Surgery | 191 Memorial Dr, Berlin, WI 54923-1241 | 2012-05-11 |
1922322429 | Andrea M. Spiker | Orthopaedic Surgery | 4602 Eastpark Blvd, Madison, WI 53718-2002 | 2010-03-26 |
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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.