OrganizationActive
Integrative Pain Management Sc
NPI 1124613732 · Anesthesiology Physician · De Pere, WI
Provider details
- NPI number
- 1124613732
- Entity type
- Organization
- Primary specialty
- Anesthesiology PhysicianAllopathic & Osteopathic Physicians
- Parent organization
- Integrative Pain Management, Sc
- Organization subpart
- Yes
- Authorized official
- John Joseph, Owner(920) 532-9117
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Established profile(62/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
5 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
3108 Mid Valley Dr
De Pere, WI 54115-9436
Phone: (920) 532-9117
Street-level locationGet directions
Mailing address
3108 Mid Valley Dr
De Pere, WI 54115-9436
Registry dates
- Enumerated
- 2021-03-05
- Last updated
- 2021-03-05
- Certified
- 2021-02-15
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.