Kenosha Family Practice, S.C.

Primary specialty

Health Service Clinic/CenterTaxonomy code 261QH0100X

License

30201 Issued in WI

Legal business name

KENOSHA FAMILY PRACTICE, S.C.

Practice address

5923 Green Bay Rd
Kenosha, WI 53144-3737

Phone

(262) 652-0500

Fax

(262) 652-1928

NPI assigned

Nov 28, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Stephen P Feuerbach, MDNPI 1386608677

Title

President

Phone

(262) 652-0500

Specialties & licenses 1

Addresses

Other identifiers 2

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Stephen P Feuerbach, M.D.

  • Family Medicine Physician
  • Kenosha, WI
  • NPI 1386608677
  Authorized official Same address or phone

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

{
    "created_epoch": "1164672000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1392854400000",
    "number": "1982770095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5923 GREEN BAY RD",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531443737",
            "telephone_number": "262-652-0500",
            "fax_number": "262-652-1928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5923 GREEN BAY RD",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531443737",
            "telephone_number": "262-652-0500",
            "fax_number": "262-652-1928"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENOSHA FAMILY PRACTICE, S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-28",
        "last_updated": "2014-02-20",
        "status": "A",
        "authorized_official_last_name": "FEUERBACH",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "262-652-0500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "WI",
            "license": "30201",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "21270500",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DA2461",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kenosha County Scout Leaders Rescue Squad, Inc (Scout Leaders Rescue Squad, Inc)
• Kenosha Dentist LLC
• Kenosha Digestive Health Center LLC
• Kenosha Emergency Physicians, LLC
• Kenosha Family Dentistry
• Kenosha Family Vision Care LLC (Regner Family Vision Clinic)
• Kenosha Hand & Plastic Surgery SC
• Kenosha Hearing Aid Centers
• Kenosha Human Development Services, Inc
• Kenosha Human Development Services, Inc

• Health Service Clinic/Center in Kenosha, WI
• Providers in Kenosha, WI by specialty
• Health Service Clinic/Center in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 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.