Rock River Community Clinic, Inc

Primary specialty

Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X

Legal business name

ROCK RIVER COMMUNITY CLINIC, INC

Practice address

400 Doctors CT Ste B
Johnson Creek, WI 53038-9567

Phone

(920) 563-4372

NPI assigned

Aug 27, 2025

Organization subpart

Yes

Parent organization

ROCK RIVER COMMUNITY CLINIC, INCAs reported in NPPES

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

Authorized official

Name

Olivia Nichols

Title

Ceo/Executive Director

Phone

(262) 472-6839

Specialties & licenses 1

Addresses

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

Rock River Community Clinic4 organizations share this tax ID, including this one

Part of

Rock River Community Clinic

Other organizations with this tax ID 3

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

• Rock River Community Clinic Inc

  • Federally Qualified Health Center (FQHC)
  • Watertown, WI
  • NPI 1427717115
  NPD tax ID
• Rock River Community Clinic Inc

  • Community Health Clinic/Center
  • Jefferson, WI
  • NPI 1952060642
  NPD tax ID
• Rock River Community Clinic, Inc

  • Federally Qualified Health Center (FQHC)
  • Fort Atkinson, WI
  • NPI 1528244613
  NPD tax ID

Locations

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

{
    "created_epoch": "1756252800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1756252800000",
    "number": "1780563536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1461 W MAIN ST STE B",
            "city": "WHITEWATER",
            "state": "WI",
            "postal_code": "531901568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 DOCTORS CT STE B",
            "city": "JOHNSON CREEK",
            "state": "WI",
            "postal_code": "530389567",
            "telephone_number": "920-563-4372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROCK RIVER COMMUNITY CLINIC, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ROCK RIVER COMMUNITY CLINIC, INC",
        "enumeration_date": "2025-08-27",
        "last_updated": "2025-08-27",
        "certification_date": "2025-08-27",
        "status": "A",
        "authorized_official_last_name": "NICHOLS",
        "authorized_official_first_name": "OLIVIA",
        "authorized_official_title_or_position": "CEO/EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "262-472-6839"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Nancy Ryan, APNP
• Emily Scharrer, RN
• Pamela J Schuhmacher, RN, PEDS VENT/TRACH
• Jessica Moore Schuster, MD
• Latisha A Smith-Chase, M.D.

• Federally Qualified Health Center (FQHC) in Johnson Creek, WI
• Providers in Johnson Creek, WI by specialty
• Federally Qualified Health Center (FQHC) in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.