North Reach Healthcare LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

NORTH REACH HEALTHCARE LLC

Practice address

3120 Riverside Ave
Gate B Building 1
Marinette, WI 54143-1123

Phone

(715) 732-2075

Fax

(715) 732-2152

NPI assigned

Oct 14, 2005

Last updated

Nov 13, 2014By 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

Carol P Hipke

Title

Business Director

Phone

(715) 732-2075

Specialties & licenses 5

Addresses

Locations

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

{
    "created_epoch": "1129248000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1415836800000",
    "number": "1952390783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3120 RIVERSIDE AVE",
            "address_2": "GATE B BUILDING 1",
            "city": "MARINETTE",
            "state": "WI",
            "postal_code": "541431123",
            "telephone_number": "715-732-2075",
            "fax_number": "715-732-2152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3120 RIVERSIDE AVE",
            "address_2": "GATE B BUILDING 1",
            "city": "MARINETTE",
            "state": "WI",
            "postal_code": "541431123",
            "telephone_number": "715-732-2075",
            "fax_number": "715-732-2152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH REACH HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-14",
        "last_updated": "2014-11-13",
        "status": "A",
        "authorized_official_last_name": "HIPKE",
        "authorized_official_first_name": "CAROL",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "BUSINESS DIRECTOR",
        "authorized_official_telephone_number": "715-732-2075"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "WI",
            "license": "52D0710136",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Marinette, WI
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2014; 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.