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Contact Information

KENOSHA COMMUNITY HEALTH CENTER, INC
6226 14TH AVE
KENOSHA, WI53143
 Phone: 262-925-1350
 Fax: 262-653-2218
 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
Indicates primary specialty

NPI Profile & details for KENOSHA COMMUNITY HEALTH CENTER, INC

NPI Number 1770789489
LBN Legal business name KENOSHA COMMUNITY HEALTH CENTER, INC
Authorized official JOHN STAMPFL - (CFO)
Entity Organization
Organization subpart 1 No
Enumeration date 06/21/2007
Last updated 02/25/2026 - About 3 months ago
Identifiers
WI Medicaid 32956300
WI Medicaid 44014100
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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