KENOSHA COMMUNITY HEALTH CENTER, INC. (NPI# 1174071658) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174071658 |
| Entity Type | Organization |
| Organization Name | KENOSHA COMMUNITY HEALTH CENTER, INC. |
| Practice Address |
2310 Center St Racine WI 53403-3330 |
| Mailing Address |
625 57th St Suite 700 Kenosha WI 53140-4146 |
| Practice Telephone | 2627643608 |
| Practice Fax Number | 2627643636 |
| Mailing Telephone | 2627643608 |
| Mailing Fax Number | 2627643636 |
| Enumeration Date | 2016-09-14 |
| Last Update Date | 2016-09-14 |
| Authorized Official Name | MARY S MCHUGH-COFFEY (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 2627643608 |
| Is Organization Subpart | Y |
| Parent Organization Name | FQHC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
WI | Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942595657 | Kenosha Community Health Center, Inc. | Clinic/Center | 1330 52nd St, Suite 205, Kenosha, WI 53140-3236 | 2011-06-10 |
| 1265435960 | Kenosha Community Health Center, Inc. | Family Medicine | 4536 22nd Ave, Kenosha, WI 53140-5917 | 2005-05-27 |
| Street Address |
2310 CENTER ST |
| City | RACINE |
| State | WI |
| Zip Code | 53403-3330 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124676259 | Quality Care LLC | Clinic/Center | 2051 Mead St, Racine, WI 53403 | 2019-09-02 |
| 1073999355 | Wisconsin Lutheran Child & Family Service, Inc. | Social Worker | 6150 Taylor Avenue, Racine, WI 53403 | 2015-08-10 |
| 1457780496 | Pheynell Branch | Counselor | 1650 Wasington Ave, Racine, WI 53403 | 2013-11-08 |
| 1811278054 | Michelle Gloria Parisot | Psychologist | 1320 Wisconsin Ave., Racine, WI 53403 | 2011-09-01 |
| 1720372022 | Katie Hagen | Social Worker | 1717 Taylor Avenue, Racine, WI 53403 | 2011-06-03 |
| 1043431570 | Rita S Harris | Physical Therapy Assistant | Lakeshore Manor 1320 Wisconsin Avenue, Racine, WI 53403 | 2007-05-01 |
| 1336281336 | Linda J Hockensmith | Occupational Therapist | 4214 Sheridan Road, Racine, WI 53403 | 2007-02-13 |
| 1851447387 | Richard John Kemper | Dentist | 1509 Washington Ave, Racine, WI 53403 | 2007-01-26 |
| 1689760332 | Lester Leslie Higgenbottom | Counselor | 1820 Arlington Ave, Racine, WI 53403 | 2006-10-04 |
| 1114942315 | Access Medical Center, LLC | Clinic/Center | 4216 Old Green Bay Rd, Racine, WI 53403 | 2006-07-12 |
| Find all providers in zip 53403 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366762825 | Wirt County Health Services Association, Inc | Clinic/Center | 906 Elm St, Racine, OH 45771-8902 | 2010-06-08 |
| 1851445241 | Community Health Systems, Inc. | Clinic/Center | 2405 Northwestern Av, Ste 200, Racine, WI 53404-2534 | 2007-01-22 |
| 1295962652 | Community Health Systems, Inc. | Clinic/Center | 2405 Northwestern Av, Ste 200, Racine, WI 53404-2534 | 2009-06-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326693847 | Scenic Bluffs Health Center, Inc | Clinic/Center | 100 Blackhawk Dr, Viroqua, WI 54665-1315 | 2019-08-02 |
| 1942718762 | Sixteenth Street Community Health Centers, Inc. | Clinic/Center | 2607 S 5th St, Milwaukee, WI 53207-1418 | 2018-01-15 |
| 1659884716 | The Lakes Community Health Center, Inc | Clinic/Center | 15954 Rivers Edge Dr Ste 304, Hayward, WI 54843-7800 | 2017-11-13 |
| 1275056632 | Outreach Community Health Centers, Inc. | Clinic/Center | 9120 W Hampton Ave Ste 119, Milwaukee, WI 53225-4960 | 2017-07-18 |
| 1437695038 | Scenic Bluffs Health Center, Inc. | Clinic/Center | 200 West North Street, Norwalk, WI 54648 | 2017-01-06 |
| 1841742673 | The Lakes Community Health Center, Inc | Clinic/Center | 300 Main Street West, Ashland, WI 54806-3696 | 2016-10-27 |
| 1841652021 | Scenic Bluffs Health Center, Inc. | Clinic/Center | 201 E Franklin St Rm B3, Sparta, WI 54656-1803 | 2016-03-25 |
| 1366844003 | Scenic Bluffs Health Center, Inc | Clinic/Center | 201 E Franklin St # B3, Sparta, WI 54656-1803 | 2014-09-25 |
| 1679983423 | The Lakes Community Health Center, Inc | Clinic/Center | 524 Bissell Street, White Lake, WI 54491 | 2014-05-02 |
| 1144593815 | Sixteenth Street Community Health Centers Inc | Clinic/Center | 309 E North St., Waukesha, WI 53188 | 2012-02-10 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.