# CHIPPEWA VALLEY ORTHOPEDICS AND SPORTS MEDICINE CLINIC SC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1699778829
- **Authorized official:** DR. AUSTIN JAY CROW M.D. (PRESIDENT)
- **Authorized official phone:** (715) 832-1400

## Contact information

- **Practice address:** 1200 OAKLEAF WAY STE A, ALTOONA, WI 54720-2217
- **Practice address phone:** (715) 832-1400
- **Practice address fax:** (715) 832-4187
- **Mailing address:** 1200 OAKLEAF WAY STE A, ALTOONA, WI 54720-2217
- **Mailing address phone:** (715) 832-1400
- **Mailing address fax:** (715) 832-4187

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207T00000X | Neurological Surgery Physician | — | NULL | — |
| 207T00000X | Neurological Surgery Physician | — | — | — |
| 207X00000X | Orthopaedic Surgery Physician | — | NULL | Yes |
| 207X00000X | Orthopaedic Surgery Physician | — | — | Yes |
| 208VP0014X | Interventional Pain Medicine Physician | 54216 | WI | — |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | — | NULL | — |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | — | — | — |
| 261QM1200X | Magnetic Resonance Imaging (MRI) Clinic/Center | — | NULL | — |
| 261QP2000X | Physical Therapy Clinic/Center | — | NULL | — |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | WI | — |
| 363A00000X | Physician Assistant | — | NULL | — |
| 363A00000X | Physician Assistant | — | — | — |

## Other

- **Enumeration date:** 05/23/2005
- **Last updated:** 06/04/2026

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 100249466 | — | WI |
| 05 | — | 100272795 | — | WI |
| 05 | — | 21278700 | — | WI |
| 01 | — | 220399400 | OWCP | WI |
| 01 | — | 2416091 | UNITED HEALTHCARE | WI |
| 05 | — | 41741700 | — | WI |
| 01 | — | 542R9CH | BCBS OF MN | WI |
| 01 | — | ========= | BLUE CROSS BLUE SHIELD | WI |