NPIMap

Organization Active NPI

Northreach Healthcare LLC

Doing business as Peshtigo Family Medicine

  • Family Medicine Physician
  • Peshtigo, WI
National Provider Identifier
1528235033
Registry record updated Mar 29, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
NORTHREACH HEALTHCARE LLC
Doing business as
Peshtigo Family Medicine
Practice address
441 French St
Peshtigo, WI 54157-1203
Phone
(715) 582-9949
Fax
(715) 582-4464
NPI assigned
May 14, 2008
Last updated
Mar 29, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2013

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

Authorized official

Name
Carol Hipke
Title
Director of Business Services
Phone
(715) 732-2078

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary

Addresses

Primary practice location

441 French St
Peshtigo, WI 54157-1203

Mailing address

3120 Riverside Ave
Gate B Building 1
Marinette, WI 54143-1123
Phone (715) 732-2075

Other identifiers 1

IdentifierTypeStateIssuer
43060200MedicaidWI

Other names 1

  • Peshtigo Family Medicine Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Northreach8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

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

Locations

441 French St
Peshtigo, WI 54157
Phone (715) 582-3622

NPI Registry JSON

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

{
    "created_epoch": "1210723200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1364515200000",
    "number": "1528235033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3120 RIVERSIDE AVE",
            "address_2": "GATE B BUILDING 1",
            "city": "MARINETTE",
            "state": "WI",
            "postal_code": "541431123",
            "telephone_number": "715-732-2075",
            "fax_number": "715-732-2072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "441 FRENCH ST",
            "city": "PESHTIGO",
            "state": "WI",
            "postal_code": "541571203",
            "telephone_number": "715-582-9949",
            "fax_number": "715-582-4464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHREACH HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-14",
        "last_updated": "2013-03-29",
        "status": "A",
        "authorized_official_last_name": "HIPKE",
        "authorized_official_first_name": "CAROL",
        "authorized_official_title_or_position": "DIRECTOR OF BUSINESS SERVICES",
        "authorized_official_telephone_number": "715-732-2078"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "43060200",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Peshtigo Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Peshtigo, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2013; 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.