DR. TIMOTHY S MOLOGNE


Address: 2105 E Enterprise Ave # 111, Appleton, WI 54913
Phone: 9207316611

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).

Provider Overview

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

Taxonomy

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

Other Provider Identifier

State Issuer Identifier Type Code
WI BC/BS 391821816017 01

Provider Secondary Practice Location

Address Telephone Number Fax Number
277 Altenhofen Dr, Appleton, WI 549138401 9209931643 9209931645

Office Location

Street Address 2105 E ENTERPRISE AVE # 111
City APPLETON
State WI
Zip Code 54913

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NPI Name Taxonomy Address Enumeration
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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
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Taxonomy Information

Taxonomy Code 207XX0005X
Grouping Allopathic & Osteopathic Physicians
Classification Orthopaedic Surgery
Specialization Sports Medicine

Taxonomy Definition

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

Providers in the same taxonomy and state

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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Competitor

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City APPLETON
Zip Code 54913

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Dataset Information

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.

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