Active NPI
Customized Health Care Services, LLC
- Internal Medicine Physician
- Green Bay, WI
National Provider Identifier
1962347641
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- Legal business name
- CUSTOMIZED HEALTH CARE SERVICES, LLC
- Practice address
- 108 Packerland Dr Ste D1
Green Bay, WI 54303-4862 - Phone
- (920) 545-5109
- Fax
- (920) 593-9159
- NPI assigned
- Apr 21, 2026
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Brian Woodbridge, MD
- Title
- Owner
- Phone
- (920) 545-5109
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | |||
| Internal Medicine Physician | 207R00000X | Primary |
Addresses
Primary practice location
108 Packerland Dr Ste D1
Green Bay, WI 54303-4862
Mailing address
108 Packerland Dr Ste D1
Green Bay, WI 54303-4862
Phone (920) 545-5109
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI
Enrollment records 1
National Provider Directory
National Provider DirectoryLocations
2848 Memorial Dr
Ste A
Two Rivers, WI 54241
Practitioners & affiliated clinicians
Practitioners 3
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Internal Medicine Physician
- Green Bay, WI
- NPI 1720055817
-
- Family Medicine Physician
- Kewaunee, WI
- NPI 1033234406
-
- Physician Assistant
- Green Bay, WI
- NPI 1316117500
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1776729600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1776729600000",
"number": "1962347641",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "108 PACKERLAND DR STE D1",
"city": "GREEN BAY",
"state": "WI",
"postal_code": "543034862",
"telephone_number": "920-545-5109",
"fax_number": "920-593-9159"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "108 PACKERLAND DR STE D1",
"city": "GREEN BAY",
"state": "WI",
"postal_code": "543034862",
"telephone_number": "920-545-5109",
"fax_number": "920-593-9159"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CUSTOMIZED HEALTH CARE SERVICES, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2026-04-21",
"last_updated": "2026-04-21",
"certification_date": "2026-04-21",
"status": "A",
"authorized_official_last_name": "WOODBRIDGE",
"authorized_official_first_name": "BRIAN",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "920-545-5109",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Family Medicine",
"state": null,
"license": null,
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Green Bay, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.