OrganizationActive
Premier Surgical of Wisconsin Sc
NPI 1679671408 · Surgery Physician · Maintowoc, WI
Premier Surgical of Wisconsin Sc is a Surgery Physician organization in Maintowoc, WI (NPI 1679671408).
Provider details
- NPI number
- 1679671408
- Entity type
- Organization
- Primary specialty
- Surgery PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Kimberly Ridl, President(920) 686-7900
- License
- 19677020 (WI)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Detailed profile(90/100 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
940 Maritime Dr
Ste 4
Maintowoc, WI 54220-2960
Phone: (920) 686-7900
Fax: (920) 686-7984
Street-level locationGet directions
Mailing address
940 Maritime Dr
Manitowoc, WI 54220-2960
Registry dates
- Enumerated
- 2006-09-20
- Last updated
- 2023-08-08
- Certified
- 2023-08-08
Frequently asked questions
- What is Premier Surgical of Wisconsin Sc's NPI number?
- Premier Surgical of Wisconsin Sc's National Provider Identifier (NPI) is 1679671408, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Premier Surgical of Wisconsin Sc?
- Premier Surgical of Wisconsin Sc is classified in the NPPES registry as Surgery Physician (Allopathic & Osteopathic Physicians).
- Where is Premier Surgical of Wisconsin Sc located?
- Premier Surgical of Wisconsin Sc's practice location on file with NPPES is 940 Maritime Dr, Maintowoc, WI 54220-2960.
- What is Premier Surgical of Wisconsin Sc's phone number?
- The practice phone number listed in the NPPES registry for Premier Surgical of Wisconsin Sc is (920) 686-7900.
- Who is the authorized official for Premier Surgical of Wisconsin Sc?
- The authorized official listed on Premier Surgical of Wisconsin Sc's NPPES record is Kimberly Ridl, President. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Premier Surgical of Wisconsin Sc's NPI active?
- Yes — Premier Surgical of Wisconsin Sc's NPI (1679671408) is active in the NPPES registry as of the last update on 2023-08-08.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.