Froedtert South Medical Group
LBN: Froedtert South, Inc.
Froedtert South Medical Group is an health care organization with primary practice located at 6308 8Th Ave , Kenosha WI 53143. The organization recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Ambulatory Health Care Facilities / Clinic/Center, Ambulatory Health Care Facilities / Multi-Specialty. Allopathic & Osteopathic Physicians / Family Medicine is the primary health care specialty.
Froedtert South, Inc. can be contacted via phone (262) 656-2718, or through Kelley, Thomas J via phone (262) 577-8113.
Contact Information
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | ||
| Ambulatory Health Care Facilities / Clinic/Center | 261Q00000X | ||
| Ambulatory Health Care Facilities / Multi-Specialty | 261QM1300X |
Profile Details
| NPI number | 1558305284 |
|---|---|
| LBN Legal business name | Froedtert South, Inc. |
| DBA Doing business as | Froedtert South Medical Group |
| Authorized official | Kelley, Thomas J |
| Entity | Organization |
| Organization subpart 1 | Yes |
| Enumeration date | Jun 15th, 2006 |
| Last updated | Mar 15th, 2023 - about 2 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1558305284 | NPPES |
| Wisconsin | MEDICAID | 32815500 | |
| Wisconsin | Other | CR0320 | |
| Wisconsin | Other | 213742 |
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