CHN MEDICAL CENTER GREEN LAKE – NPI #1568622280
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.

CHN MEDICAL CENTER GREEN LAKE is a provider located in GREEN LAKE, WI. NPPES has assigned the NPI number 1568622280 to CHN MEDICAL CENTER GREEN LAKE on June 16, 2008. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “CHN MEDICAL CENTER GREEN LAKE” is a dba name, the actual legal business name for this organization is COMMUNITY MEDICAL CENTER OF GREEN LAKE, LLC. 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 12 years ago on May 02, 2014. 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 CHN MEDICAL CENTER GREEN LAKE below.

NPI Profile for
COMMUNITY MEDICAL CENTER OF GREEN LAKE, LLC

NPI Number
1568622280
Enumeration Date

(about 18 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
COMMUNITY MEDICAL CENTER OF GREEN LAKE, LLC
Doing Business As (dba): CHN MEDICAL CENTER GREEN LAKE
Primary location
670 COUNTY ROAD A
GREEN LAKE, WI 54941
Phone: (920) 294-0100 Fax: (920) 294-0123
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
THOMAS KRYSTOWIAK
CHIEF FINANCIAL OFFICER
Phone: (920) 361-1313
Updated
Identifiers

Identifiers for CHN MEDICAL CENTER GREEN LAKE

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
MEDICAIDWI21329400
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)
WI 44378

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.