Green Bay Heartcare S.C.

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

Legal business name

GREEN BAY HEARTCARE S.C.

Practice address

1727 Shawano Ave
Suite 201
Green Bay, WI 54303-3268

Phone

(920) 496-8877

Fax

(920) 496-3061

NPI assigned

Jan 23, 2006

Last updated

Aug 22, 2020By 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

Peter A. Fergus, MDNPI 1639157936

Title

President

Phone

(920) 496-8877

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 2

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.

• Peter Fergus, M.D.

  • Cardiovascular Disease Physician
  • Green Bay, WI
  • NPI 1639157936
  NPD (past) Authorized official
• Ghazwan Katmeh, M.D.

  • Cardiovascular Disease Physician
  • Sheboygan, WI
  • NPI 1518945831
  NPD (past)

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

{
    "created_epoch": "1137974400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1306816574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1727 SHAWANO AVE",
            "address_2": "SUITE 201",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543033268",
            "telephone_number": "920-496-8877",
            "fax_number": "920-496-3061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1727 SHAWANO AVE",
            "address_2": "SUITE 201",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543033268",
            "telephone_number": "920-496-8877",
            "fax_number": "920-496-3061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREEN BAY HEARTCARE S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FERGUS",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "920-496-8877",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32864300",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Green Bay Doulas, LLC
• Green Bay Emergency Medicine Services S.C.
• Green Bay Emergency Physicians, LLC
• Green Bay Emergency Physicians, LLC
• Green Bay Family Dental LLC
• Green Bay II Al Operations LLC
• Green Bay Oncology, LTD
• Green Bay Orthopedics Limited
• Green Bay Plastic Surgical Assoc (Green Bay Plastic Surgical Associates)
• Green Bay Podiatry Associates SC

• Cardiovascular Disease Physician in Green Bay, WI
• Providers in Green Bay, WI by specialty
• Cardiovascular Disease Physician in Wisconsin

• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.