Organization Active NPI

Visiting Nurse Community Care, Inc.

  • Community Health Clinic/Center
  • Kenosha, WI
National Provider Identifier
1154394005
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health Clinic/CenterTaxonomy code 261QC1500X
Legal business name
VISITING NURSE COMMUNITY CARE, INC.
Practice address
600 52ND St
Suite 300
Kenosha, WI 53140-3423
Phone
(262) 656-8400
Fax
(262) 656-8406
NPI assigned
Feb 10, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Debra Jene Hertzberg
Title
President
Phone
(262) 656-8400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Clinic/Center 261QC1500X Primary

Addresses

Primary practice location

600 52ND St
Suite 300
Kenosha, WI 53140-3423

Mailing address

600 52ND St
Suite 300
Kenosha, WI 53140-3423
Phone (262) 656-8400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080205000395 WI Part B Supplier - Mass Immunization (Roster Biller Only) 6901988591 Practice locations: Kenosha, WI

National Provider Directory

National Provider Directory
Tax ID family
Visiting Nurse Community Care2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

372 North Ave
Antioch, IL 60002
Phone (847) 838-5271

600 52nd St
Kenosha, WI 53140

5159 6th Ave
Kenosha, WI 53140

NPI Registry JSON

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

{
    "created_epoch": "1139529600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1154394005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 52ND ST",
            "address_2": "SUITE 300",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531403423",
            "telephone_number": "262-656-8400",
            "fax_number": "262-656-8406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 52ND ST",
            "address_2": "SUITE 300",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531403423",
            "telephone_number": "262-656-8400",
            "fax_number": "262-656-8406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VISITING NURSE COMMUNITY CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HERTZBERG",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_middle_name": "JENE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "262-656-8400"
    },
    "taxonomies": [
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.