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PRIMARY CONNECTION HEALTH CARE INC. NPI 1457370744


NPI Information

NPI: 1457370744
Provider Name: PRIMARY CONNECTION HEALTH CARE, INC.

Doing Business As: BRIDGE COMMUNITY HEALTH CLINIC

Classification: Clinic/Center - 261QF0400X
Entity Type: Organization

Specialization: Federally Qualified Health Center (FQHC)

CLIA Number: 52D0899620

Address:
181 N 2ND STREET
WAUSAU, WI
ZIP 54403
Phone: (715) 848-4884
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PRIMARY CONNECTION HEALTH CARE, INC. is a federally qualified health center (fqhc) clinic center in Wausau, WI. PRIMARY CONNECTION HEALTH CARE, INC. NPI is 1457370744. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Bridge Community Health Clinic.

The provider's business location address is:

181 N 2ND STREET
WAUSAU, WI
ZIP 54403
Phone: (715) 848-4884
Fax: (715) 845-5385

The provider's authorized official is Jennifer Smith .
The authorized official title is Executive Director and has the following contact phone number (715) 848-4884.

The CLIA number assigned to this NPI record is 52D0899620 - community clinic with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 7/18/2006 and was last updated on 6/30/2017.


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
1122300000XDentist5377-800WISCONSINNo
2124Q00000XDental Hygienist5377-800WISCONSINNo
3207Q00000XFamily Medicine5377-800WISCONSINNo
4208000000XPediatrics5377-800WISCONSINNo
5261QF0400XClinic/CenterFederally Qualified Health Center (FQHC)Yes

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
139256400MEDICAIDWISCONSIN
2521809MEDICARE OSCAR/CERTIFICATION
3521809MEDICARE OSCAR/CERTIFICATIONWISCONSIN
439245MEDICARE ID-TYPE UNSPECIFIEDWISCONSIN
5000039245MEDICARE PIN

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: 11/14/2023

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.