Racine Digestive Health Center LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

RACINE DIGESTIVE HEALTH CENTER LLC

Practice address

10340 Washington Ave Ste 100
Sturtevant, WI 53177-1607

Phone

(414) 908-6500

Fax

(414) 908-6565

NPI assigned

Feb 11, 2020

Last updated

Jan 8, 2025By 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

Amy Jo Burns

Title

Director Revenue Cycle Management

Phone

(262) 970-7825

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Listed as

Racine Digestive Health Center LLCCCN 52C0001131

Medicare certification status

ActiveFrom the Provider of Services file

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

CLIA laboratory certificates

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

{
    "created_epoch": "1581379200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736294400000",
    "number": "1659903292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2801 W KINNICKINNIC RIVER PKWY STE 1080",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532153689",
            "telephone_number": "414-908-6506",
            "fax_number": "414-908-6510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10340 WASHINGTON AVE STE 100",
            "city": "STURTEVANT",
            "state": "WI",
            "postal_code": "531771607",
            "telephone_number": "414-908-6500",
            "fax_number": "414-908-6565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RACINE DIGESTIVE HEALTH CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-11",
        "last_updated": "2025-01-08",
        "certification_date": "2025-01-08",
        "status": "A",
        "authorized_official_last_name": "BURNS",
        "authorized_official_first_name": "AMY",
        "authorized_official_middle_name": "JO",
        "authorized_official_title_or_position": "DIRECTOR REVENUE CYCLE MANAGEMENT",
        "authorized_official_telephone_number": "262-970-7825"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristin Lynn Osgood Kotlewski, DDS
• Sabrina G Philip, D.D.S.
• Todd Edward Pienkos, DDS
• Pillpack LLC
• Psychiatric Services of Racine, LLP
• Shelly M Rasmussen, RN
• Marguerite Richardson, O.D.
• Anna Marie Rodriguez, MS, RDN, LD, DIPACLM
• Juliana Sardenberg-Melcher, DMD, MS
• Jennifer L Scheels, RN, BSN

• Ambulatory Surgical Clinic/Center in Sturtevant, WI
• Providers in Sturtevant, WI by specialty
• Ambulatory Surgical Clinic/Center in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2025; 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.