OrganizationActive
Community Pediatrics Sc
NPI 1275749566 · Pediatrics Physician · Beaver Dam, WI
Provider details
- NPI number
- 1275749566
- Entity type
- Organization
- Primary specialty
- Pediatrics PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Dorothy Larson, Account Manager(920) 885-3305
Specialties & taxonomies
Allopathic & Osteopathic Physicians
- Pediatric Nurse Practitioner363LP0200X
Physician Assistants & Advanced Practice Nursing Providers
Profile Score
Detailed profile(89/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 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
109 Warren St Ste 4
Beaver Dam, WI 53916-3082
Phone: (920) 885-3305
Fax: (920) 885-5506
Street-level locationGet directions
Mailing address
109 Warren St Ste 4
Beaver Dam, WI 53916-3082
Registry dates
- Enumerated
- 2007-05-15
- Last updated
- 2010-04-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.