NPIMap

Organization Active NPI

Northreach Healthcare Lab and Xray

  • Clinical Medical Laboratory
  • Marinette, WI
National Provider Identifier
1659600575
Registry record updated Dec 24, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
52-D0394498 Issued in WI
Legal business name
NORTHREACH HEALTHCARE LAB AND XRAY
Practice address
3123 Shore Dr
Suite 103
Marinette, WI 54143-4287
Phone
(715) 735-8046
Fax
(715) 735-8047
NPI assigned
Dec 24, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 24, 2009

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

Authorized official

Name
Dr. Calvin Nogler, MD
Title
Director
Phone
(715) 735-8046

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X 52-D0394498 WI Primary

Addresses

Primary practice location

3123 Shore Dr
Suite 103
Marinette, WI 54143-4287

Mailing address

3123 Shore Dr
Suite 103
Marinette, WI 54143-4287
Phone (715) 735-8046

National Provider Directory

National Provider Directory
Tax ID family
Northreach Healthcare LLC8 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

3123 Shore Dr
Ste 103
Marinette, WI 54143
Phone (715) 735-8046

NPI Registry JSON

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

{
    "created_epoch": "1261612800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1261612800000",
    "number": "1659600575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3123 SHORE DR",
            "address_2": "SUITE 103",
            "city": "MARINETTE",
            "state": "WI",
            "postal_code": "541434287",
            "telephone_number": "715-735-8046",
            "fax_number": "715-735-8047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3123 SHORE DR",
            "address_2": "SUITE 103",
            "city": "MARINETTE",
            "state": "WI",
            "postal_code": "541434287",
            "telephone_number": "715-735-8046",
            "fax_number": "715-735-8047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHREACH HEALTHCARE LAB AND XRAY",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-24",
        "last_updated": "2009-12-24",
        "status": "A",
        "authorized_official_last_name": "NOGLER",
        "authorized_official_first_name": "CALVIN",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "715-735-8046",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "WI",
            "license": "52-D0394498",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marinette, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 24, 2009; 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.