FROEDTERT SOUTH MEDICAL GROUP – NPI #1558305284
Family Medicine

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

Health Care Provider Taxonomy Code for Family Medicine

FROEDTERT SOUTH MEDICAL GROUP is a provider located in KENOSHA, WI. NPPES has assigned the NPI number 1558305284 to FROEDTERT SOUTH MEDICAL GROUP on June 15, 2006. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “FROEDTERT SOUTH MEDICAL GROUP” is a dba name, the actual legal business name for this organization is FROEDTERT SOUTH, INC.. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 207Q00000X from the Health Care Provider Taxonomy code set, which is classified as Family Medicine.

The NPI profile was previously updated about 3 years ago on Mar 15, 2023. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for FROEDTERT SOUTH MEDICAL GROUP below.

NPI Profile for
FROEDTERT SOUTH, INC.

NPI Number
1558305284
Enumeration Date

(about 20 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
FROEDTERT SOUTH, INC.
Doing Business As (dba): FROEDTERT SOUTH MEDICAL GROUP
Primary location
6308 8TH AVE
KENOSHA, WI 53143
Phone: (262) 656-2718 Fax:
Mailing address
PO BOX 130
KENOSHA, WI 53141-0130
Phone: (262) 656-2930 Fax: (262) 656-2749
Organization Subpart
Yes - FROEDTERT SOUTH MEDICAL GROUP is subpart of another organization.
Authorized Official
THOMAS KELLEY
VICE PRESIDENT & CFO
Phone: (262) 577-8113
Updated
Certification Date
Mar 15, 2023

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Identifiers

Identifiers for FROEDTERT SOUTH MEDICAL GROUP

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
otherMEDICAREIL213742
otherMEDICARE RRWICR0320
medicaidWI32815500
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
207Q00000X
- Family Medicine (Primary)
261QM1300X
- Clinic/Center / Multi-Specialty
261Q00000X
- Clinic/Center

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.