CMH PRIMARY CARE CLINIC-MOUNTAIN – NPI #1962533455
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

CMH PRIMARY CARE CLINIC-MOUNTAIN is a provider located in MOUNTAIN, WI. NPPES has assigned the NPI number 1962533455 to CMH PRIMARY CARE CLINIC-MOUNTAIN on March 08, 2007. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “CMH PRIMARY CARE CLINIC-MOUNTAIN” is a dba name, the actual legal business name for this organization is CMH PRIMARY CARE CLINIC MOUTAIN-PHYSICIAN DISPENSARY. 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 4 years ago on Dec 23, 2021. 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 CMH PRIMARY CARE CLINIC-MOUNTAIN below.

NPI Profile for
CMH PRIMARY CARE CLINIC MOUTAIN-PHYSICIAN DISPENSARY

NPI Number
1962533455
Enumeration Date

(more than 19 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
CMH PRIMARY CARE CLINIC MOUTAIN-PHYSICIAN DISPENSARY
Doing Business As (dba): CMH PRIMARY CARE CLINIC-MOUNTAIN
Primary location
14353 HWY 32 & 64
MOUNTAIN, WI 54149
Phone: (715) 276-1600 Fax: (715) 276-1800
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
DOUGLAS GREMBAN
PHYSICIAN DISPENSARY
Phone: (715) 276-1600
Updated
Certification Date
Dec 23, 2021

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 CMH PRIMARY CARE CLINIC-MOUNTAIN

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
OTHERGREMBAN BCWI395585708005
OTHERNCPDPWI5128904
MEDICAIDWI31756500
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 23967-020

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.

Endpoint

Health Information Exchange (HEI)

HEI is the mobilization of health care information electronically across organizations within a region, community or hospital system. Endpoints provide a simple and secure way for participants to send authenticated, encrypted health information directly to known, trusted recipients over the internet such as primary care physicians, specialists, hospitals, labs, etc.

Endpoint
community_memorial_hospital_transitions_of_care2201223@ewd.direct.hshs.org
Endpoint type
Direct Messaging Address
Endpoint Description
Content Type
OTHER
Affiliation
N
Endpoint Location
14353 HWY 32 & 64,
MOUNTAIN, WI 77025-1669