Dousman Clinic, S.C.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

DOUSMAN CLINIC, S.C.

Practice address

124 Siegler St
Green Bay, WI 54303-2636

Phone

(920) 494-9661

NPI assigned

Jun 1, 2007

Organization subpart

No

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

Authorized official

Name

Ms. Jan E Reimer

Title

Clinic Manager

Phone

(920) 494-9661

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

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

CLIA laboratory certificates

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mark K Jenson, M.D.

  • Family Medicine Physician
  • Green Bay, WI
  • NPI 1598727000
  Medicare reassignment Care Compare group NPD
• Matthew Krueger Jenson, MD

  • Family Medicine Physician
  • Green Bay, WI
  • NPI 1063917243
  Medicare reassignment Care Compare group NPD
• Teresa Marie Gajewski, PA

  • Physician Assistant
  • Appleton, WI
  • NPI 1508142001
  Medicare reassignment

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

{
    "created_epoch": "1180656000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1351036800000",
    "number": "1265634331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "124 SIEGLER ST",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543032636",
            "telephone_number": "920-494-9661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 SIEGLER ST",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543032636",
            "telephone_number": "920-494-9661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOUSMAN CLINIC, S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-01",
        "last_updated": "2012-10-24",
        "status": "A",
        "authorized_official_last_name": "REIMER",
        "authorized_official_first_name": "JAN",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "CLINIC MANAGER",
        "authorized_official_telephone_number": "920-494-9661",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "WI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32786100",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mehul Mahendra Doshi, MD
• Karim Adel Ahmed Mohamed Doughem, MD
• Donn M Dougherty, M.D.
• William Scott Dougherty, MD
• Joshua P Douma, CRNA
• Brian Thomas Dovorany, D.C.
• Megan Downing
• Josie R Doxtater, AU.D.
• Elaine Jean Doxtator, SAC-IT
• Dr Hallam Chiropractic LLC

• Family Medicine Physician in Green Bay, WI
• Providers in Green Bay, 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 Oct 24, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.