Partnership Community Health Center, Inc
Organization Active NPI Federally Qualified Health Center (FQHC) · Waupaca, WI
NPI 1689294159 · NPPES record last updated Feb 22, 2024
Key facts
- NPI
- 1689294159
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Federally Qualified Health Center (FQHC) 261QF0400X
- Legal business name
- PARTNERSHIP COMMUNITY HEALTH CENTER, INC
- Practice address
- 825 W Fulton St
Waupaca, WI 54981-1471 - Phone
- (920) 731-7445
- NPI assigned
- Apr 24, 2020
- Organization subpart
- No
Authorized official
- Name
- Kristene Stacker, RN
- Title
- Ceo
- Phone
- (920) 731-7445
Other NPIs on the same Medicare enrollment 1
Practitioners 27
-
Leah K Amboise, LCSW
-
Mackenzie Broeren, APRN, PMHNP-BC
-
Maria E Cripe, APRN
-
Heather N Mikkelson, LCSW,CSAC
-
Iris N Torres, MD
-
Ashley M Utech, APRN
-
Theresa Adamczyk, DDS
-
Ronald Lee Dudley, D.D.S.
-
James Michael Fakler, D.D.S.
-
William Alexander Hammond, D.D.S.
-
Heather R Hassell, DDS
-
Jacob W Malone, DMD
-
Amitoj Kaur Mavi, DDS
-
Jacqueline Page, RDH
-
Lynn C Perry, RDH
-
Nikita George Tongas, DDS
-
Ying Wang, DDS
-
Kyle Whiteside, DMD
-
Doris Yang, DDS
-
Ahmed G Abou Khadija, DDS
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20140213001404 | WI | Part B Supplier - Clinic/Group Practice | 2062452600 |
Receives reassigned benefits from 10 practitioners 1 other NPI on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Appleton, WI; Oshkosh, WI; Waupaca, WI |
National Provider Directory
Locations
5471 W Waterford Ln
Appleton, WI 54913
913 S West Ave
Appleton, WI 54915
1800 Appleton Rd
Menasha, WI 54952
Phone (920) 731-6601
1814 Appleton Rd
Menasha, WI 54952
Phone (920) 931-1150
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Federally Qualified Health Center (FQHC) | 261QF0400X | Yes |
Addresses
Primary practice location
825 W Fulton St
Waupaca, WI 54981-1471
Mailing address
5337 W Grande Market Dr
Appleton, WI 54913-8442
Phone (920) 731-7445
Other providers in Waupaca, WI
- Michelle R Oetken
- Emily A Olson
- Orthopedic & Spine Therapy of Waupaca SC
- Orthopedic & Spine Therapy of Waupaca, SC
- Lamont Parrott
- Gabrielle Ann Patri
- Nancy Ann Pejsa
- Melissa Perzinski
- Robert Lester Peterson
- Dawn M Pflugradt
All providers in Waupaca, WI · Federally Qualified Health Center (FQHC) in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 22, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.