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GENESIS MEDICAL CENTER OF KENOSHA S.C. NPI 1063456424


NPI Information

NPI: 1063456424
Provider Name: GENESIS MEDICAL CENTER OF KENOSHA, S.C.
Classification: Internal Medicine - 207R00000X
Entity Type: Organization
Address:
1020 35TH ST
KENOSHA, WI
ZIP 53140
Phone: (262) 652-3500
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GENESIS MEDICAL CENTER OF KENOSHA, S.C. is an internal medicine in Kenosha, WI. The provider is a physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. GENESIS MEDICAL CENTER OF KENOSHA, S.C. NPI is 1063456424. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1020 35TH ST
KENOSHA, WI
ZIP 53140-902
Phone: (262) 652-3500
Fax: (262) 925-8353

The provider's authorized official is Jean Garretto .
The authorized official title is Office Manager and has the following contact phone number (262) 652-3500.

The enumeration date for this NPI number is 6/16/2006 and was last updated on 4/20/2008.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207Q00000XFamily MedicineNo
2207RR0500XInternal MedicineRheumatologyNo
3207R00000XInternal MedicineYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1=========012OTHERWISCONSINBLUE CROSS BLUE SHIELD
221301500MEDICAIDWISCONSIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.