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WISCONSIN SPINE AND PAIN SC
NPI 1649098856
Durable Medical Equipment & Medical Supplies in Green Bay, WI

Active since September 27, 2024CLIA 52D2207665 · Waiver
2595 DEVELOPMENT DRIVE, STE 150, GREEN BAY, WI 54311(920) 204-6758 Get Directions Write a Review

NPPES record last updated: September 27, 2024. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Wisconsin Spine And Pain Sc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

WISCONSIN SPINE AND PAIN SC (NPI 1649098856) is a healthcare organization registered as a durable medical equipment & medical supplies in Green Bay, Wisconsin and active in the NPI registry since September 2024. The organization holds a CLIA Waiver certificate valid through December 29, 2026 and lists Michael Jung, Owner, as its authorized official.

NPPES Registry Identity

NPI1649098856
Entity TypeOrganization
Primary Taxonomy332B00000X
Legal Business NameWISCONSIN SPINE AND PAIN SC
Location Address2595 DEVELOPMENT DRIVE, STE 150Green Bay, WI 54311-4267
Mailing AddressDept. Ch 17057Palatine, IL 60055-7057 · (920) 204-6758
Phone(920) 204-6758
Organization SubpartNo
Authorized OfficialMichael JungOwner · (608) 710-8162
Enumeration DateSeptember 27, 2024
NPPES CertifiedSeptember 26, 2024
✔ NPI 1649098856 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDurable Medical Equipment & Medical SuppliesSuppliers
Taxonomy Code332B00000X
Definition
A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time.
2595 DEVELOPMENT DRIVE, STE 150, Green Bay, WI 54311
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CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 52D2207665

Wisconsin Spine And Pain Sc · Green Bay, WI
Active · expires Dec 29, 2026
CLIA Number52D2207665
Laboratory TypePhysician Office
Certificate Effective DateDecember 30, 2024
Certificate Expiration DateDecember 29, 2026
Laboratory DirectorDr. Raymond S. Sohn
Laboratory Phone(920) 838-6426
Laboratory LocationWisconsin Spine And Pain Sc2595 Development Drive Suite 150, Green Bay, WI 54311
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Wisconsin Spine And Pain Sc's NPI number?

The NPI number for Wisconsin Spine And Pain Sc is 1649098856. It was assigned to this organization in the NPPES registry on September 27, 2024.

Where is Wisconsin Spine And Pain Sc located?

Wisconsin Spine And Pain Sc is located at 2595 Development Drive, Ste 150, Green Bay, WI 54311. The listed phone number is (920) 204-6758.

What is Wisconsin Spine And Pain Sc's specialty?

The primary specialty registered for this NPI is Durable Medical Equipment & Medical Supplies with taxonomy code 332B00000X.

Does Wisconsin Spine And Pain Sc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 52D2207665) is associated with this NPI, valid through December 29, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Wisconsin Spine And Pain Sc was last updated on September 27, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 22 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.