Kenosha Surgicenter LLC

Primary specialty

Non-Pharmacy Dispensing SiteTaxonomy code 332900000X

Legal business name

KENOSHA SURGICENTER LLC

Practice address

10105 74TH St Ste 102
Kenosha, WI 53142-7530

Phone

(262) 297-7246

Fax

(888) 701-0578

NPI assigned

Aug 23, 2022

Organization subpart

No

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

Authorized official

Name

Kevin Eugene Hooker

Title

HR

Phone

(262) 297-7246

Specialties & licenses 1

Addresses

Tax ID family

Kenosha Surgicenter2 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.

• Kenosha Surgicenter LLC

  • Ambulatory Surgical Clinic/Center
  • Kenosha, WI
  • NPI 1669111274
  NPD tax ID

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

{
    "created_epoch": "1661212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661212800000",
    "number": "1760101992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 W LAYTON AVE STE 120",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532215400",
            "telephone_number": "262-297-7246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10105 74TH ST STE 102",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531427530",
            "telephone_number": "262-297-7246",
            "fax_number": "888-701-0578"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENOSHA SURGICENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-23",
        "last_updated": "2022-08-23",
        "certification_date": "2022-08-23",
        "status": "A",
        "authorized_official_last_name": "HOOKER",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "EUGENE",
        "authorized_official_title_or_position": "HR",
        "authorized_official_telephone_number": "262-297-7246"
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kenosha Pathology Consultants
• Kenosha Radiology Center LLC.
• Kenosha Senior Living, Inc.
• Kenosha Shuttle LLC
• Kenosha Surgicenter LLC
• Kenosha Unified School District No. 1
• Kenosha Urgicare
• Kenosha Urology Clinic, S.C.
• Kenosha Vascular Lab Inc
• Kenosha Vascular Laboratory

• Non-Pharmacy Dispensing Site in Kenosha, WI
• Providers in Kenosha, WI by specialty
• Non-Pharmacy Dispensing Site in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2022; 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.