NPIMap

Organization Active NPI

Planned Parenthood of Wi, Inc.

  • Ambulatory Family Planning Facility
  • Kenosha, WI
National Provider Identifier
1104091610
Registry record updated Mar 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Family Planning FacilityTaxonomy code 261QA0005X
Legal business name
PLANNED PARENTHOOD OF WI, INC.
Practice address
3601 Roosevelt Rd
Kenosha, WI 53142-7231
Phone
(262) 654-0900
NPI assigned
Apr 25, 2008
Organization subpart
Yes
Parent organization
PLANNED PARENTHOOD OF WI, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 30, 2026

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

Authorized official

Name
Susan Marie Odegaard
Title
Director, Business Opers.
Phone
(414) 289-3796

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Family Planning Facility 261QA0005X Primary
Non-Pharmacy Dispensing Site 332900000X

Addresses

Primary practice location

3601 Roosevelt Rd
Kenosha, WI 53142-7231

Mailing address

302 N Jackson St
Milwaukee, WI 53202-5904

Other names 1

  • Kenosha Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Planned Parenthood of Wisconsin18 organizations share this tax ID, including this one
Part of
Planned Parenthood of Wisconsin

Other organizations with this tax ID 17

Organizations that report the same tax identification number in the National Provider Directory.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1209081600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1774828800000",
    "number": "1104091610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "302 N JACKSON ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532025904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3601 ROOSEVELT RD",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531427231",
            "telephone_number": "262-654-0900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PLANNED PARENTHOOD OF WI, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PLANNED PARENTHOOD OF WI, INC",
        "enumeration_date": "2008-04-25",
        "last_updated": "2026-03-30",
        "certification_date": "2026-03-30",
        "status": "A",
        "authorized_official_last_name": "ODEGAARD",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "DIRECTOR, BUSINESS OPERS.",
        "authorized_official_telephone_number": "414-289-3796"
    },
    "taxonomies": [
        {
            "code": "261QA0005X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Family Planning Facility",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kenosha",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Kenosha, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2026; 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.