NPIMap

Organization Active NPI

Northreach Healthcare LLC

  • Family Medicine Physician
  • Marinette, WI
National Provider Identifier
1811268204
Registry record updated Mar 14, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
NORTHREACH HEALTHCARE LLC
Practice address
1106 University Dr
Suite 102
Marinette, WI 54143-5110
Phone
(715) 732-2075
Fax
(715) 735-0895
NPI assigned
Jan 18, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2017

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

Authorized official

Name
Denise K Stroobants
Title
Credentialing Specialist
Phone
(920) 445-7226

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

1106 University Dr
Suite 102
Marinette, WI 54143-5110

Mailing address

PO Box 22487
Green Bay, WI 54305-2487
Phone (920) 445-7226

Other identifiers 1

IdentifierTypeStateIssuer
52D2038176OtherWICLINIC CLIA

Other names 1

  • AFTER HOURS CLINIC Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1326844800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1489449600000",
    "number": "1811268204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 22487",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543052487",
            "telephone_number": "920-445-7226",
            "fax_number": "920-445-7229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1106 UNIVERSITY DR",
            "address_2": "SUITE 102",
            "city": "MARINETTE",
            "state": "WI",
            "postal_code": "541435110",
            "telephone_number": "715-732-2075",
            "fax_number": "715-735-0895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHREACH HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-18",
        "last_updated": "2017-03-14",
        "status": "A",
        "authorized_official_last_name": "STROOBANTS",
        "authorized_official_first_name": "DENISE",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "920-445-7226"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLINIC CLIA",
            "identifier": "52D2038176",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "AFTER HOURS CLINIC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Marinette, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2017; 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.