Greendale Medical Clinic, S.C.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

GREENDALE MEDICAL CLINIC, S.C.

Practice address

6601 Northway # D
Greendale, WI 53129-1830

Phone

(414) 423-0555

Fax

(414) 423-8268

NPI assigned

Sep 26, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Marty Lubing, RN

Title

Office Manager

Phone

(414) 423-0555

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• John F Lubing, M.D.

  • Internal Medicine Physician
  • Greendale, WI
  • NPI 1669573283
  NPD
• Randy C Mathewson, M.D.

  • Internal Medicine Physician
  • Greendale, WI
  • NPI 1477654002
  NPD

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1023119666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6601 NORTHWAY # D",
            "city": "GREENDALE",
            "state": "WI",
            "postal_code": "531291830",
            "telephone_number": "414-423-0555",
            "fax_number": "414-423-8268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6601 NORTHWAY # D",
            "city": "GREENDALE",
            "state": "WI",
            "postal_code": "531291830",
            "telephone_number": "414-423-0555",
            "fax_number": "414-423-8268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREENDALE MEDICAL CLINIC, S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LUBING",
        "authorized_official_first_name": "MARTY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "414-423-0555",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32688400",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• William Peter Goulding, CCC-SLP
• Brian Goyette
• Stephen Gradinjan
• Greendale Chiropractic LLC
• Greendale Dental Associates, S.C.
• Greendale SC Hool District
• Greendale Wi Opco LLC
• Ronald John Greenwald, DVM
• Peggy P Hamby
• Shawn Ann Hannemann, M.S.

• Internal Medicine Physician in Greendale, WI
• Providers in Greendale, WI by specialty
• Internal Medicine Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.