GREEN BAY EMERGENCY PHYSICIANS LLC NPI 1083662712

NPI Information

  • NPI: 1083662712
  • Provider Name: GREEN BAY EMERGENCY PHYSICIANS, LLC
  • Classification: Emergency Medicine - 207P00000X
  • Entity Type: Organization
  • CLIA Number: 52D1033946
  • Address: 1726 SHAWANO AVE
    GREEN BAY, WI
    ZIP 54303
  • Phone: (414) 290-6718

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NPI Details

GREEN BAY EMERGENCY PHYSICIANS, LLC is an emergency medicine in Green Bay, WI. The provider is an emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. GREEN BAY EMERGENCY PHYSICIANS, LLC NPI is 1083662712. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1726 SHAWANO AVE
GREEN BAY, WI
ZIP 54303-216
Phone: (414) 290-6718
Fax: (414) 290-6755

The provider's authorized official is Karen Vaughn .
The authorized official title is Officer and has the following contact phone number (973) 251-1132.

The CLIA number assigned to this NPI record is 52D1033946 - community clinic with a certificate type of Certificate of Accreditation.

The enumeration date for this NPI number is 5/5/2006 and was last updated on 2/8/2024.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363A00000XPhysician AssistantNo
2207P00000XEmergency 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 Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
132875300MEDICAIDWISCONSIN
2120003951OTHERWISCONSINWEA
3137598401OTHERWISCONSINOWCP
4CI8038OTHERWISCONSINMEDICARE RAILROAD
5020151500OTHERWISCONSINFEDERAL BLACK LUNG PROGRA

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: 11/21/2025

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