Northwestern Medical Center SC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

14968021 Issued in WI

Legal business name

NORTHWESTERN MEDICAL CENTER SC

Practice address

1532 S Green Bay Rd
Suite 200
Racine, WI 53406-4410

Phone

(262) 631-0474

Fax

(262) 631-0476

NPI assigned

Nov 7, 2006

Organization subpart

No

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

Authorized official

Name

Kenneth J Kurt, DO

Title

President

Phone

(262) 631-0474

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Mr Pleasant Medical Center SC Innovative Health Providers Former legal business name

Locations

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

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196640000000",
    "number": "1033288816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1532 S GREEN BAY RD",
            "address_2": "SUITE 200",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "534064410",
            "telephone_number": "262-631-0474",
            "fax_number": "262-631-0476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1532 S GREEN BAY RD",
            "address_2": "SUITE 200",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "534064410",
            "telephone_number": "262-631-0474",
            "fax_number": "262-631-0476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWESTERN MEDICAL CENTER SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-07",
        "last_updated": "2007-12-03",
        "status": "A",
        "authorized_official_last_name": "KURT",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "262-631-0474",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "14968021",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "38736439001",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30038200",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mr Pleasant Medical Center SC Innovative Health Providers",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Kimberly Anne Norden, PH.D.
• Kylie S Nordness, PA-C
• Stephen Nickolas Norovich, D.D.S.
• North Central Emergency Services, LLC
• North Star Medical Transport Inc
• Carol Ann Norton, MS, LPC
• Madeleine Elizabeth Norton, CCC-SLP
• Susan Nosalik, NP
• Jason Novak, PHARMD
• Chad M Novasic, PT

• Family Medicine Physician in Racine, WI
• Providers in Racine, WI by specialty
• Family Medicine Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2007; 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.