County of Kewaunee

Primary specialty

Public Health or Welfare AgencyTaxonomy code 251K00000X

License

24068-020 Issued in WI

Legal business name

COUNTY OF KEWAUNEE

Doing business as

Kewaunee County Public Health Department

Practice address

810 Lincoln St
Kewaunee, WI 54216-1140

Phone

(920) 388-7160

Fax

(920) 388-2122

NPI assigned

Jul 25, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Cynthia Mary Kinnard, RN

Title

Public Health Director

Phone

(920) 388-7160

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Kewaunee County Public Health Department Doing business as

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• County of Kewaunee

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Kewaunee, WI
  • NPI 1366431173

  1052337060

  Same PAC ID

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

CLIA laboratory certificates

Tax ID family

County of Kewaunee2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• County of Kewaunee

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Kewaunee, WI
  • NPI 1366431173
  NPD tax ID

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Michael Eis, PHD, M.D.

  • Psychiatry Physician
  • Menomonee Falls, WI
  • NPI 1689653214
  NPD
• Jacob Kumpfer, LMFT-IT

  • Marriage & Family Therapist
  • Kewaunee, WI
  • NPI 1619497344
  NPD
• Stephen L Shopbell, MD

  • Psychiatry Physician
  • Oshkosh, WI
  • NPI 1326032335
  NPD
• Kenneth R Downing, PH.D.

  • Psychologist
  • Lincoln, NE
  • NPI 1508877614
  NPD

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1431907200000",
    "number": "1710909775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "810 LINCOLN ST",
            "city": "KEWAUNEE",
            "state": "WI",
            "postal_code": "542161140",
            "telephone_number": "920-388-7160",
            "fax_number": "920-388-2122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "810 LINCOLN ST",
            "city": "KEWAUNEE",
            "state": "WI",
            "postal_code": "542161140",
            "telephone_number": "920-388-7160",
            "fax_number": "920-388-2122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTY OF KEWAUNEE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-25",
        "last_updated": "2015-05-18",
        "status": "A",
        "authorized_official_last_name": "KINNARD",
        "authorized_official_first_name": "CYNTHIA",
        "authorized_official_middle_name": "MARY",
        "authorized_official_title_or_position": "PUBLIC HEALTH DIRECTOR",
        "authorized_official_telephone_number": "920-388-7160",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": "WI",
            "license": "24068-020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41870900",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "44006200",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kewaunee County Public Health Department",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• City of Kewaunee Wisconsin
• Charlene M Coenen, CAPSW
• Christopher Michael Coffey, BS SOCIOLOGY
• Kari Ann Cornelissen-Wied, D.C.
• County of Kewaunee
• Madelyn Devos
• Rachel L Dorner
• Emerald Shores Assisted Living, LLC
• Mark A Fuss, PA
• Scott R Gartzke, CSAC

• Public Health or Welfare Agency in Kewaunee, WI
• Providers in Kewaunee, WI by specialty
• Public Health or Welfare Agency in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2015; 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.