NPIMap

Organization Active NPI

Baycare Clinic, LLP

  • Oral and Maxillofacial Surgery (Dentist)
  • Sturgeon Bay, WI
National Provider Identifier
1124516893
Registry record updated Aug 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
Legal business name
BAYCARE CLINIC, LLP
Practice address
636 N 12TH Ave
Sturgeon Bay, WI 54235-1249
Phone
(920) 743-2001
NPI assigned
Apr 27, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2026

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

Authorized official

Name
Taylor Konkle
Title
Payor Enrollment
Phone
(920) 301-1327

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist)Group: 193200000X MULTI-SPECIALTY GROUP 1223S0112X Primary

Addresses

Primary practice location

636 N 12TH Ave
Sturgeon Bay, WI 54235-1249

Mailing address

PO Box 28900
Green Bay, WI 54324-0900
Phone (920) 490-9046

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
52D2090131Baycare Clinic, LLP636 12TH Ave, Sturgeon Bay, WI 54235Certificate of waiverJan 14, 2027

National Provider Directory

National Provider Directory
Tax ID family
Linda Zaffke11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

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

NPI Registry JSON

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

{
    "created_epoch": "1524787200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1787788800000",
    "number": "1124516893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 28900",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543240900",
            "telephone_number": "920-490-9046",
            "fax_number": "920-405-5388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "636 N 12TH AVE",
            "city": "STURGEON BAY",
            "state": "WI",
            "postal_code": "542351249",
            "telephone_number": "920-743-2001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAYCARE CLINIC, LLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-27",
        "last_updated": "2026-08-27",
        "certification_date": "2026-08-27",
        "status": "A",
        "authorized_official_last_name": "KONKLE",
        "authorized_official_first_name": "TAYLOR",
        "authorized_official_title_or_position": "PAYOR ENROLLMENT",
        "authorized_official_telephone_number": "920-301-1327"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sturgeon Bay, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.