Genesis Medical Center of Kenosha, S.C.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

GENESIS MEDICAL CENTER OF KENOSHA, S.C.

Practice address

1020 35TH St
Kenosha, WI 53140-1902

Phone

(262) 652-3500

Fax

(262) 925-8353

NPI assigned

Jun 16, 2006

Last updated

Apr 20, 2008By 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

Jean Garretto

Title

Office Manager

Phone

(262) 652-3500

Specialties & licenses 3

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1150416000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1063456424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1020 35TH ST",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531401902",
            "telephone_number": "262-652-3500",
            "fax_number": "262-925-8353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 35TH ST",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531401902",
            "telephone_number": "262-652-3500",
            "fax_number": "262-925-8353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENESIS MEDICAL CENTER OF KENOSHA, S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-16",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "GARRETTO",
        "authorized_official_first_name": "JEAN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "262-652-3500"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "21301500",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michelle Ann Gehring
• Charleen Marie Geissman, M.S.
• Madison Rose Geliche, DMD
• Delores Mary Gemignani, PTA
• Genesis Chiropractic Clinic, Inc.
• Genoa Healthcare LLC
• Heather Gentry, PTA
• Kerri Ann Gerhardy, LPC
• Diane M Gerlach, DO
• Andrew Joseph Germann, PHARMD

• Internal Medicine Physician in Kenosha, WI
• Providers in Kenosha, 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 Apr 20, 2008; 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.