Community Health Network

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

45822 Issued in WI

Legal business name

COMMUNITY HEALTH NETWORK

Doing business as

CHN Medical Center EastRidge

Practice address

W832 State Road 91
Ste 3
Berlin, WI 54923-8821

Phone

(920) 361-6400

Fax

(920) 361-6407

NPI assigned

Mar 16, 2011

Last updated

Jul 7, 2011By 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

Steven Ruedinger

Title

Vice President

Phone

(920) 361-5988

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• CHN Medical Center EastRidge Doing business as

Locations

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

{
    "created_epoch": "1300233600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1309996800000",
    "number": "1134428105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "W832 STATE ROAD 91",
            "address_2": "STE 3",
            "city": "BERLIN",
            "state": "WI",
            "postal_code": "549238821",
            "telephone_number": "920-361-6400",
            "fax_number": "920-361-6407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "W832 STATE ROAD 91",
            "address_2": "STE 3",
            "city": "BERLIN",
            "state": "WI",
            "postal_code": "549238821",
            "telephone_number": "920-361-6400",
            "fax_number": "920-361-6407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY HEALTH NETWORK",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-16",
        "last_updated": "2011-07-07",
        "status": "A",
        "authorized_official_last_name": "RUEDINGER",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "920-361-5988"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "45822",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "11011000",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CHN Medical Center EastRidge",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Central Wisconsin Orthopedics and Sports Medicine
• Craig S Chertack, M.D.
• CHN Community Health
• City of Berlin
• Michelle Clauson, RDN
• Community Health Network Inc (CHN Orthopedics & Sports Medicine)
• County of Green Lake (Green Lake County DHHS)
• Victoria Cross, APNP
• Maria Graziella Cruz-Apolinario, MD
• Mary Swieskowski Cummins, M.D.

• Family Medicine Physician in Berlin, WI
• Providers in Berlin, 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 Jul 7, 2011; 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.