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Contact Information

KENOSHA COMMUNITY HEALTH CENTER, INC.
930 DR MARTIN LUTHER KING DR # 3
RACINE, WI53404-3008
 Phone: 262-656-0044
 Fax: 262-764-3636
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Federally Qualified Health Center (FQHC)

261QF0400X B4[14] Federally Qualified Health Center
 

Family Medicine

207Q00000X 08 Physician/Family Practice
 

Pediatrics

363LP0200X 50 Nurse Practitioner
Indicates primary specialty

NPI Profile & details for KENOSHA COMMUNITY HEALTH CENTER, INC.

NPI # 1215823406
LBN Legal business name KENOSHA COMMUNITY HEALTH CENTER, INC.
Authorized official JOHN STAMPFL - (CFO)
Entity Organization
Organization subpart 1 Yes
Enumeration date 06/16/2025
Last updated 02/25/2026 - About 3 months ago
Identifiers
WI Medicaid 100328514
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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