KENOSHA COMMUNITY HEALTH CENTER, INC. (NPI# 1942595657) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1942595657 |
Entity Type | Organization |
Organization Name | KENOSHA COMMUNITY HEALTH CENTER, INC. |
Other Organization Name | KENOSHA COMMUNITY CENTER CLINIC |
Practice Address |
1330 52nd St Suite 205 Kenosha WI 53140-3236 |
Mailing Address |
625 57th St Suite 700 Kenosha WI 53140-4146 |
Practice Telephone | 2626560044 |
Practice Fax Number | 2627643636 |
Mailing Telephone | 2626560044 |
Mailing Fax Number | 2627643636 |
Enumeration Date | 2011-06-10 |
Last Update Date | 2014-07-23 |
Authorized Official Name | MARY COFFEY (EXECUTIVE DIRECTOR) |
Authorized Official Telephone | 2627643608 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
Other Name | Type Code |
---|---|
Kenosha Community Center Clinic | Doing Business As Name - Organization |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1174071658 | Kenosha Community Health Center, Inc. | Clinic/Center | 2310 Center St, Racine, WI 53403-3330 | 2016-09-14 |
1265435960 | Kenosha Community Health Center, Inc. | Family Medicine | 4536 22nd Ave, Kenosha, WI 53140-5917 | 2005-05-27 |
Street Address |
1330 52ND ST SUITE 205 |
City | KENOSHA |
State | WI |
Zip Code | 53140-3236 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1225663396 | Lydia Zopf | Counselor | 2001 Alford Park Dr., Carthage College, Kenosha, WI 53140 | 2020-03-09 |
1952949406 | Rotate Rehabilitation and Performance | Physical Therapist | 5606 6th Avenue Suite Ll9, Kenosha, WI 53140 | 2019-12-16 |
1134778590 | Brenda Chiapetta | Registered Nurse | 3233 23rd Ave, Kenosha, WI 53140 | 2019-09-09 |
1275003394 | Kimberly Shaffner | Family Medicine | 4536 22nd Avenue, Kenosha, WI 53140 | 2018-12-01 |
1659863389 | Bart L Mengo | Contractor | 1715 60th Street, Kenosha, WI 53140 | 2018-05-30 |
1093182941 | Guided Wellness Counseling | Community/Behavioral Health | 1112 56th St, Kenosha, WI 53140 | 2015-08-26 |
1376970764 | Stacey L Andersen | Acupuncturist | 5603 7th Ave, Kenosha, WI 53140 | 2013-10-01 |
1841467438 | Deborah Schwerdtfeger | Occupational Therapy Assistant | 3415 Sheridan Road, Woodstock Rehab Dept, Kenosha, WI 53140 | 2008-05-13 |
1942492020 | Rebecca Ann Burdette | Counselor | 920 60th Street, Renosha, WI 53140 | 2007-08-13 |
1851598619 | Aurora Medical Group, Inc. | Durable Medical Equipment & Medical Supplies | 2707 15th Place, Kenosha, WI 53140 | 2007-06-27 |
Find all providers in zip 53140 |
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 |
---|---|---|---|---|
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 |
1174071658 | Kenosha Community Health Center, Inc. | Clinic/Center | 2310 Center St, Racine, WI 53403-3330 | 2016-09-14 |
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 |
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.