Church Health Services, Inc.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

27426020 Issued in WI

Legal business name

CHURCH HEALTH SERVICES, INC.

Practice address

115 N Center St
Beaver Dam, WI 53916-2119

Phone

(920) 887-1766

Fax

(920) 887-2322

NPI assigned

Mar 4, 2016

Last updated

Mar 4, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Thea O'Connor

Title

Accounting and Finance Coordinator

Phone

(920) 887-1766

Specialties & licenses 1

Addresses

Tax ID family

Church Health Services Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

• Church Health Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Beaver Dam, WI
  • NPI 1003271180
  NPD tax ID
• Church Health Services, Inc.

  • Dental Clinic/Center
  • Beaver Dam, WI
  • NPI 1154743177
  NPD tax ID

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

{
    "created_epoch": "1457049600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1457049600000",
    "number": "1922468891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 N CENTER ST",
            "city": "BEAVER DAM",
            "state": "WI",
            "postal_code": "539162119",
            "telephone_number": "920-887-1766",
            "fax_number": "920-887-2322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 N CENTER ST",
            "city": "BEAVER DAM",
            "state": "WI",
            "postal_code": "539162119",
            "telephone_number": "920-887-1766",
            "fax_number": "920-887-2322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHURCH HEALTH SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-04",
        "last_updated": "2016-03-04",
        "status": "A",
        "authorized_official_last_name": "O'CONNOR",
        "authorized_official_first_name": "THEA",
        "authorized_official_title_or_position": "ACCOUNTING AND FINANCE COORDINATOR",
        "authorized_official_telephone_number": "920-887-1766"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "27426020",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Micheal E Ceizyk, PT
• Lyndsey Christenson, APNP
• Carol Christie, CRNA
• Church Health Services
• Church Health Services, Inc.
• City of Beaver Dam Et Al (Beaver Dam Fire Department)
• Susan Dorsch Clark, OTR
• Richard Clutson, MD
• Edward F Cody, MD
• Robert A Coe, MD

• Family Medicine Physician in Beaver Dam, WI
• Providers in Beaver Dam, WI by specialty
• Family Medicine Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2016; 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.