KENOSHA COMMUNITY HEALTH CENTER, INC.


Address: 1330 52nd St, Suite 205, Kenosha, WI 53140-3236
Phone: 2626560044

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).

Provider Overview

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

Taxonomy

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 Provider/Organization Names

Other Name Type Code
Kenosha Community Center Clinic Doing Business As Name - Organization

Other Provider IDs and Locations

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

Office Location

Street Address 1330 52ND ST
SUITE 205
City KENOSHA
State WI
Zip Code 53140-3236

Providers in the same zip code

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
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Taxonomy Information

Taxonomy Code 261QF0400X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Federally Qualified Health Center (FQHC)

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and state

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
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Competitor

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City KENOSHA
Zip Code 53140

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Dataset Information

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.

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