N.E.W. Community Clinic, LTD

Primary specialty

Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X

Legal business name

N.E.W. COMMUNITY CLINIC, LTD

Practice address

610 N Broadway
Green Bay, WI 54303-3426

Phone

(920) 437-7206

NPI assigned

Apr 12, 2007

Last updated

Aug 21, 2024By 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

Keith Szerkins, MSA

Title

Cfo

Phone

(920) 940-8088

Specialties & licenses 1

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Enrolled in WI2 enrollments

Enrollment records 2

NPI to CCN mapping 3

The Medicare certification numbers (CCNs) connected to NPI 1487878328. Details of each certification follow.

• CCN 521859 Federally qualified health center · Active · Details
• CCN 521017 Federally qualified health center · Active · Details
• CCN 521851 Federally qualified health center · Active · Name & address match · Details

Federally qualified health center certification: CCN 521859

Legal name

N.E.W. COMMUNITY CLINIC, LTD.

Certification status

Active

Provider type (POS)

Federally qualified health center

Participating since

Aug 24, 2016

Last certification

Aug 24, 2016

Ownership / control type

For profit – corporation

Organization structure

CorporationNon-profit

Incorporated

Jul 21, 1971 in WI

Enrollment address

2740 W Mason St
Green Bay, WI 54303-4966

Federally qualified health center certification: CCN 521017

Legal name

N.E.W. COMMUNITY CLINIC, LTD.

Certification status

Active

Provider type (POS)

Federally qualified health center

Participating since

Sep 18, 2023

Last certification

Sep 18, 2023

Ownership / control type

For profit – corporation

Organization structure

CorporationNon-profit

Incorporated

Jul 21, 1971 in WI

Enrollment address

610 N Broadway
Green Bay, WI 54303-3426

Federally qualified health center certification: CCN 521851

Legal name

NEW COMMUNITY CLINIC

Certification status

Active

Provider type (POS)

Federally qualified health center

Participating since

Sep 4, 2014

Last certification

Sep 4, 2014

Ownership / control type

For profit – partnership

Facility address

622 Bodart Street
Green Bay, WI 54301

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

CLIA laboratory certificates

Locations

All disclosed owners & managing parties 8

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

Practitioners 32

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.

• Patrick Thomas Berg, DDS

  • Dentist
  • Sturgeon Bay, WI
  • NPI 1770195810
  NPD
• Gregory Matthew Bottei, MD

  • Internal Medicine Physician
  • Green Bay, WI
  • NPI 1245255561
  NPD
• Amanda Cole Vanden Heuvel, RDH

  • Dental Hygienist
  • Green Bay, WI
  • NPI 1982363222
  NPD
• Karen Glogauerreich

  • Social Worker
  • Green Bay, WI
  • NPI 1750087698
  NPD
• Kaylee Elizabeth Hintz, MSW, APSW

  • Clinical Social Worker
  • Green Bay, WI
  • NPI 1740017920
  NPD
• Jennifer Kilmer, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Green Bay, WI
  • NPI 1942188206
  NPD
• Michael Allan Lamarca, D.D.S.

  • General Practice Dentistry
  • Green Bay, WI
  • NPI 1689795957
  NPD
• Gildardo Martinez Juarez, RD

  • Registered Dietitian
  • Green Bay, WI
  • NPI 1760226294
  NPD
• Erica Soletski, MSW, LCSW

  • Social Worker
  • Green Bay, WI
  • NPI 1205532827
  NPD
• Savannah Steckler

  • Clinical Social Worker
  • Green Bay, WI
  • NPI 1477432144
  NPD
• Katherine Ann Szerkins, LCSW

  • Clinical Social Worker
  • De Pere, WI
  • NPI 1619690195
  NPD
• Erica Lynn Van Dyke, RDN

  • Registered Dietitian
  • Green Bay, WI
  • NPI 1528930252
  NPD

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

{
    "created_epoch": "1176336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724198400000",
    "number": "1487878328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "622 BODART ST",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543014923",
            "telephone_number": "920-437-9773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 N BROADWAY",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543033426",
            "telephone_number": "920-437-7206"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2740 W Mason St",
            "address_purpose": "LOCATION",
            "city": "Green Bay",
            "state": "WI",
            "postal_code": "543034966",
            "country_code": "US",
            "telephone_number": "920-437-7206",
            "fax_number": "920-437-0984",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "622 Bodart St",
            "address_purpose": "LOCATION",
            "city": "Green Bay",
            "state": "WI",
            "postal_code": "543014923",
            "country_code": "US",
            "telephone_number": "920-437-9773",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "424 S Monroe Ave",
            "address_purpose": "LOCATION",
            "city": "Green Bay",
            "state": "WI",
            "postal_code": "543014054",
            "country_code": "US",
            "telephone_number": "920-544-0346",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "N.E.W. COMMUNITY CLINIC, LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-12",
        "last_updated": "2024-08-21",
        "certification_date": "2024-08-21",
        "status": "A",
        "authorized_official_last_name": "SZERKINS",
        "authorized_official_first_name": "KEITH",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "920-940-8088",
        "authorized_official_credential": "MSA"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "WI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100078454",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32957300",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100078475",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41860101",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100078554",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Benjamin K Mwai, PA-C
• My Innovative Services
• Ruth I Myers, MS,CADC
• Myeyedr Optometry of Wisconsin, LLC (MyEyeDr.)
• Myeyedr Optometry of Wisconsin, LLC (MyEyeDr.)
• N.E.W. Snoring & Sleep Apnea Center, S.C.
• Chelsea Nabak
• Mary Lou Nabak, RDH
• Thomas D Nachtwey, O.T.
• Jenifer Nagel, OT

• Federally Qualified Health Center (FQHC) in Green Bay, WI
• Providers in Green Bay, WI by specialty
• Federally Qualified Health Center (FQHC) in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• 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.