PROGRESSIVE COMMUNITY HEALTH CENTERS, INC. (NPI# 1720153653) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720153653 |
| Entity Type | Organization |
| Organization Name | PROGRESSIVE COMMUNITY HEALTH CENTERS, INC. |
| Other Organization Name | LISBON AVENUE HEALTH CENTER |
| Practice Address |
3522 W Lisbon Ave Milwaukee WI 53208-1953 |
| Mailing Address |
Po Box 080257 Milwaukee WI 53208-8004 |
| Practice Telephone | 4149358000 |
| Practice Fax Number | 4143443396 |
| Mailing Telephone | 4149358000 |
| Mailing Fax Number | 4147550058 |
| Enumeration Date | 2006-11-24 |
| Last Update Date | 2017-01-25 |
| Authorized Official Name | CANDICE COLE (CFO) |
| Authorized Official Telephone | 4149358000 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
| N | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians | ||
| N | 207V00000X | Obstetrics & Gynecology | Allopathic & Osteopathic Physicians | ||
| N | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians | ||
| N | 1041C0700X |
Social Worker Specialization: Clinical |
Behavioral Health & Social Service Providers | ||
| N | 124Q00000X | Dental Hygienist | Dental Providers | ||
| N | 122300000X | Dentist | Dental Providers | ||
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities | ||
| N | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 32957400 | 05 |
| Other Name | Type Code |
|---|---|
| Lisbon Avenue Health Center | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801262746 | Progressive Community Health Centers, Inc. | Family Medicine | 1218 W Kilbourn Ave, Milwaukee, WI 53233-1330 | 2015-08-14 |
| 1023484961 | Progressive Community Health Centers, Inc. | Family Medicine | 945 N 12th St, Urgent Care, Milwaukee, WI 53233-1305 | 2015-08-14 |
| Street Address |
3522 W LISBON AVE |
| City | MILWAUKEE |
| State | WI |
| Zip Code | 53208-1953 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215915194 | Benjamin Salazar Yabut Jr. | Family Medicine | 3522 W Lisbon Ave, Milwaukee, WI 53208-1953 | 2006-01-03 |
| 1508492885 | Max Carpenter | Dentist | 3522 W Lisbon Ave, Milwaukee, WI 53208-1953 | 2020-03-18 |
| 1538712658 | Joshua David Spierer | Social Worker | 3522 W Lisbon Ave, Milwaukee, WI 53208-1953 | 2019-07-17 |
| 1477106730 | Toni Delagardelle | Nurse Practitioner | 3522 W Lisbon Ave, Milwaukee, WI 53208-1953 | 2019-07-16 |
| 1477114452 | Samantha Ellen Neuroth | Dental Hygienist | 3522 W Lisbon Ave, Milwaukee, WI 53208-1953 | 2019-06-21 |
| 1376014563 | Shannon M Engel | Dental Hygienist | 3522 W Lisbon Ave, Milwaukee, WI 53208-1953 | 2018-12-16 |
| 1831675362 | Francesca Napolitano | Pharmacist | 3522 W Lisbon Ave, Milwaukee, WI 53208-1953 | 2018-07-18 |
| 1508382276 | Smriti Madrecha | Dentist | 3522 W Lisbon Ave, Milwaukee, WI 53208 | 2017-08-15 |
| 1588103097 | Jason Holt | Dentist | 3522 W Lisbon Ave, Milwaukee, WI 53208-1953 | 2017-02-16 |
| 1972058824 | Courtney L Schmitz | Nurse Practitioner | 3522 W Lisbon Ave, Milwaukee, WI 53208 | 2016-08-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831662535 | Mary Ehrgood | Marriage & Family Therapist | Aurora Family Service, 3200 W Highland Blvd, Milwaukee, WI 53208 | 2019-01-04 |
| 1265976989 | Redeeming Hearts Home Care Agency, LLC | Home Health | 3223 W Lloyd St, Milwaukee, WI 53208 | 2016-12-14 |
| 1205379500 | Benjamin Michael Bleck-owens | Counselor | 5508 W. Vliet Street, Milwaukee, WI 53208 | 2016-11-18 |
| 1730552662 | John Bosnjak | Pharmacist | 3727 W. Wisconsin Ave., Milwaukee, WI 53208 | 2015-10-30 |
| 1588074991 | Quad/med, LLC | Clinic/Center | 1301 West Canal Street, Milwaukee, WI 53208 | 2014-05-07 |
| 1629407226 | Dhanya Jayadevan Nair | Marriage & Family Therapist | 3200 W. Highland Blvd., Milwaukee, WI 53208 | 2013-11-04 |
| 1619215704 | Nurturing Concepts LLC | In Home Supportive Care | 5722 W North Ave, Milwaukee, WI 53208 | 2013-01-23 |
| 1831447986 | Amy Schuldt | Registered Nurse | 3727 W. Wisconsin Aveune, Milwaukee, WI 53208 | 2012-08-21 |
| 1144588922 | Grassroots Empowerment Project Inc | Community Health Worker | 3732 W Wisconsin Ave, Milwaukee, WI 53208 | 2012-04-30 |
| 1245468180 | Elizabeth Adams | Registered Nurse | 1917 N 34 Th St, Milwaukee, WI 53208 | 2009-06-30 |
| Find all providers in zip 53208 | ||||
| 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 |
|---|---|---|---|---|
| 1942718762 | Sixteenth Street Community Health Centers, Inc. | Clinic/Center | 2607 S 5th St, Milwaukee, WI 53207-1418 | 2018-01-15 |
| 1275056632 | Outreach Community Health Centers, Inc. | Clinic/Center | 9120 W Hampton Ave Ste 119, Milwaukee, WI 53225-4960 | 2017-07-18 |
| 1649559642 | Sixteenth Street Community Health Centers, Inc. | Clinic/Center | 730 W Washington St., Milwaukee, WI 53204-2310 | 2011-08-08 |
| 1205318102 | Outreach Community Health Centers, Inc. | Clinic/Center | 1730 S 13th St, Milwaukee, WI 53204-3201 | 2018-09-06 |
| 1487144697 | Outreach Community Health Centers, Inc. | Clinic/Center | 1027 N 9th St, Milwaukee, WI 53233-1411 | 2018-05-14 |
| 1245720499 | Outreach Community Health Centers, Inc. | Clinic/Center | 1730 N 7th St, Milwaukee, WI 53205-1701 | 2018-05-14 |
| 1174910012 | Sixteenth Street Community Health Centers, Inc | Clinic/Center | 1727 S 9th St, Milwaukee, WI 53204-3519 | 2015-04-17 |
| 1528304797 | Sixteenth Street Community Health Center, Inc | Clinic/Center | 2906 S 20th St, Milwaukee, WI 53215-3732 | 2012-12-17 |
| 1316980709 | Milwaukee Health Services, Inc. | Clinic/Center | 2555 N Martin Luther King Dr, Milwaukee, WI 53212-2709 | 2006-06-14 |
| 1891732244 | Milwaukee Health Services Inc | Clinic/Center | 8200 W Silver Spring Dr, Attention: Tito Izard, M.d., Milwaukee, WI 53218-2552 | 2006-06-01 |
| Find all providers in MILWAUKEE | ||||
Please comment or provide details below to improve the information on PROGRESSIVE COMMUNITY HEALTH CENTERS, INC..
| 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.