NORTHWOODS FAMILY PHYSICAL MEDICINE OF WISCONSIN, S.C. (NPI# 1518446558) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518446558 |
| Entity Type | Organization |
| Organization Name | NORTHWOODS FAMILY PHYSICAL MEDICINE OF WISCONSIN, S.C. |
| Other Organization Name | NORTHWOODS FAMILY PHYSICAL MEDICINE |
| Practice Address |
2360a Duck Creek Pkwy Ste 2 Green Bay WI 54303-3377 |
| Practice Telephone | 9203013024 |
| Practice Fax Number | 9203013049 |
| Mailing Telephone | 9203013024 |
| Mailing Fax Number | 9203013049 |
| Enumeration Date | 2018-08-10 |
| Last Update Date | 2018-08-10 |
| Authorized Official Name | DR. KIMBERLY SCARLASSARA (CLINIC DIRECTOR) |
| Authorized Official Telephone | 9203013024 |
| Authorized Official Credential | DC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM2500X |
Clinic/Center Specialization: Medical Specialty |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Northwoods Family Physical Medicine | Doing Business As Name - Organization |
| Street Address |
2360A DUCK CREEK PKWY STE 2 |
| City | GREEN BAY |
| State | WI |
| Zip Code | 54303-3377 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033689633 | Shannon Deanne Schwartz | Registered Nurse | 2360a Duck Creek Pkwy Ste 2, Green Bay, WI 54303-3377 | 2018-11-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952921033 | Ashley Marie Vandermoss | Social Worker | 1601 W Mason Street, Green Bay, WI 54303 | 2020-04-20 |
| 1598307423 | Jean Marie Castaneda | Case Manager/Care Coordinator | 2517 N. Court, Green Bay, WI 54303 | 2019-10-11 |
| 1215579552 | Integrated Treatment Centers, LLC | Clinic/Center | 2311 W Mason Street, Green Bay, WI 54303 | 2019-10-08 |
| 1003460551 | Affordable Dentures & Implants - Green Bay, S.c. | Dentist | 1800-c W. Mason Street, Green Bay, WI 54303 | 2019-08-01 |
| 1164940375 | Kaeley Rae Blaney | Student in an Organized Health Care Education/Training Program | 2088 Memorial Drive #208, Green Bay, WI 54303 | 2017-09-07 |
| 1518498047 | Treatment Providers LLC | Clinic/Center | 2731 N Packerland Dr Ste A, Green Bay, WI 54303 | 2017-03-26 |
| 1851840565 | Back To Balance Chiropractic, LLC | Chiropractor | 110 Packerland Drive, Suite B, Green Bay, WI 54303 | 2016-09-23 |
| 1710361001 | Matthew Lemay | Acupuncturist | 727 E Walnut, Suite B2, Green Bay, WI 54303 | 2015-07-16 |
| 1144600149 | Carrie Jean Banaszak | Counselor | 1039 Mason Street, Green Bay, WI 54303 | 2015-06-04 |
| 1174921993 | Kensey Meyer | Occupational Therapy Assistant | 1555 Dousman Road, Seymour, WI 54303 | 2014-12-10 |
| Find all providers in zip 54303 | ||||
| Taxonomy Code | 261QM2500X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Medical Specialty |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer). |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629498522 | Asana Health & Wellness LLC | Clinic/Center | 2372 S Oneida St, Green Bay, WI 54304-5256 | 2014-04-18 |
| 1043501356 | Steven Victor Bittorf | Clinic/Center | 2505 Parkwood Dr, Green Bay, WI 54304-1956 | 2011-04-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104222330 | Premier Cardiovascular Institute of Wisconsin LLC | Clinic/Center | 1309 S 54th St, Milwaukee, WI 53214-3404 | 2014-11-17 |
| 1467792457 | Vein Care Associates S.c. | Clinic/Center | 215 Corporate Drive, Suite H, Beaver Dam, WI 53916-3124 | 2013-02-27 |
| 1447532403 | Lavender Lotus Acupuncture LLC | Clinic/Center | 130 Gregor St, Waterloo, WI 53594-1224 | 2011-09-15 |
| 1881927812 | Gail A Weinand | Clinic/Center | 203 Schiek Plz, Rhinelander, WI 54501-3364 | 2009-09-09 |
| 1932368685 | Center for Stomach & Intestinal Disorders Ltd | Clinic/Center | 2300 N Mayfair Rd Ste 725, Wauwatosa, WI 53226-1533 | 2008-06-07 |
| 1568641439 | Daniel L. Gauerkei Dba Broadway Vision Center | Clinic/Center | 815 W Fulton St, Suite 103, Waupaca, WI 54981-1405 | 2007-10-29 |
| 1174723084 | Bruns Chiropractic Office Sc | Clinic/Center | 1429 North Ave, Sheboygan, WI 53083-4760 | 2007-07-19 |
| 1891919411 | Raether Chiropractic Office, S.c. | Clinic/Center | 511 E Rhine St, Elkhart Lake, WI 53020-0673 | 2007-04-13 |
| 1073666269 | Dimitrios P Bousounis Md | Clinic/Center | 200 W Silver Spring Dr Ste 255, Glendale, WI 53217-5058 | 2007-01-19 |
| 1629144944 | Raether Chiropractic Office,s.c. | Clinic/Center | 2625 Altona Ave, New Holstein, WI 53061-9542 | 2006-11-28 |
| Find all providers with the same taxonomy | ||||
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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.