NPIMap

Organization Active NPI

Northreach Healthcare LLC

  • Clinical Medical Laboratory
  • Marinette, WI
National Provider Identifier
1003953019
Registry record updated Apr 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
52D0394498
Legal business name
NORTHREACH HEALTHCARE LLC
Practice address
3200 Shore Dr
Upper Level
Marinette, WI 54143-4202
Phone
(715) 732-8645
Fax
(715) 732-8652
NPI assigned
Jan 31, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Denise K Stroobants
Title
Credentialing Specialist
Phone
(920) 445-7226

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X 52D0394498 Primary
Clinical Medical Laboratory 291U00000X 52D2088280 WI

Addresses

Primary practice location

3200 Shore Dr
Upper Level
Marinette, WI 54143-4202

Mailing address

3120 Riverside Ave
Gate B Building 1
Marinette, WI 54143-6007
Phone (715) 732-2075

Other identifiers 2

IdentifierTypeStateIssuer
CLIA NUMBEROtherWI52D2088280
52D0394498OtherWICLIA NUMBER

Other names 1

  • NorthReach Lab Doing business as

National Provider Directory

National Provider Directory

Locations

3200 Shore Dr
Uppr
Marinette, WI 54143
Phone (715) 732-8645

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170201600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1429142400000",
    "number": "1003953019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3120 RIVERSIDE AVE",
            "address_2": "GATE B BUILDING 1",
            "city": "MARINETTE",
            "state": "WI",
            "postal_code": "541436007",
            "telephone_number": "715-732-2075",
            "fax_number": "715-732-2092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 SHORE DR",
            "address_2": "UPPER LEVEL",
            "city": "MARINETTE",
            "state": "WI",
            "postal_code": "541434202",
            "telephone_number": "715-732-8645",
            "fax_number": "715-732-8652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHREACH HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-31",
        "last_updated": "2015-04-16",
        "status": "A",
        "authorized_official_last_name": "STROOBANTS",
        "authorized_official_first_name": "DENISE",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "920-445-7226"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": "52D0394498",
            "primary": true
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "WI",
            "license": "52D2088280",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "52D2088280",
            "identifier": "CLIA NUMBER",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA NUMBER",
            "identifier": "52D0394498",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NorthReach Lab",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Marinette, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.