NPIMap

Organization Active NPI

Lakeshore Community Health Care, Inc.

  • Federally Qualified Health Center (FQHC)
  • Manitowoc, WI
National Provider Identifier
1245502673
Registry record updated Oct 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
LAKESHORE COMMUNITY HEALTH CARE, INC.
Practice address
601 Buffalo St
Manitowoc, WI 54220-6817
Phone
(920) 686-2333
Fax
(920) 783-6392
NPI assigned
Feb 1, 2012
Organization subpart
Yes
Parent organization
LAKESHORE COMMUNITY HEALTH CARE, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 3, 2014

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

Authorized official

Name
Michele M Schmitt
Title
Program Director
Phone
(920) 686-2333

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

601 Buffalo St
Manitowoc, WI 54220-6817

Mailing address

PO Box 959
Sheboygan, WI 53082-0959
Phone (920) 783-6633

Other names 1

  • Community Clinics of Manitowoc County Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130605000747 WI Part B Supplier - Clinic/Group Practice 3173773124 Receives reassigned benefits from 46 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Manitowoc, WI; Sheboygan, WI; West Bend, WI

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Part of
Lakeshore Community Health

Locations

601 Buffalo St
Manitowoc, WI 54220
Phone (920) 686-2333

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1328054400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1412294400000",
    "number": "1245502673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 959",
            "city": "SHEBOYGAN",
            "state": "WI",
            "postal_code": "530820959",
            "telephone_number": "920-783-6633",
            "fax_number": "920-783-6392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 BUFFALO ST",
            "city": "MANITOWOC",
            "state": "WI",
            "postal_code": "542206817",
            "telephone_number": "920-686-2333",
            "fax_number": "920-783-6392"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKESHORE COMMUNITY HEALTH CARE, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LAKESHORE COMMUNITY HEALTH CARE, INC",
        "enumeration_date": "2012-02-01",
        "last_updated": "2014-10-03",
        "status": "A",
        "authorized_official_last_name": "SCHMITT",
        "authorized_official_first_name": "MICHELE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PROGRAM DIRECTOR",
        "authorized_official_telephone_number": "920-686-2333"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Community Clinics of Manitowoc County",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Manitowoc, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2014; 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.