Kaukauna Clinic, S.c. | |
305 E 12th St Kaukauna WI 54130-2865 | |
(920) 766-4656 | |
(920) 766-4659 |
Full Name | Kaukauna Clinic, S.c. |
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Speciality | Family Medicine |
Location | 305 E 12th St, Kaukauna, Wisconsin |
Authorized Official Name and Position | Bruce R Danz (PRESIDENT) |
Authorized Official Contact | 9207664656 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Kaukauna Clinic, S.c. 305 E 12th St Kaukauna WI 54130-2865 Ph: (920) 766-4656 | Kaukauna Clinic, S.c. 305 E 12th St Kaukauna WI 54130-2865 Ph: (920) 766-4656 |
NPI Number | 1457317273 |
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Provider Enumeration Date | 04/21/2006 |
Last Update Date | 08/22/2020 |
Medicare PECOS PAC ID | 5597765891 |
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Medicare Enrollment ID | O20070111000068 |
Identifier | Type | State | Issuer |
---|---|---|---|
1457317273 | NPI | - | NPPES |
32792500 | Medicaid | WI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Provider Name | Timothy P Culligan |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1447216767 PECOS PAC ID: 8921045683 Enrollment ID: I20050413001184 |
Provider Name | Jennifer L Baumgart |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1386978260 PECOS PAC ID: 2062550726 Enrollment ID: I20091117000690 |
Provider Name | Bruce R Danz |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1386600666 PECOS PAC ID: 3678573979 Enrollment ID: I20100522000158 |
Provider Name | Joseph C Graunke |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1316903222 PECOS PAC ID: 4587664883 Enrollment ID: I20100524000024 |
Provider Name | Gregory A Johnson |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1578529863 PECOS PAC ID: 7214937515 Enrollment ID: I20100524000033 |
Provider Name | Paul H Russo |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1164488458 PECOS PAC ID: 8123028420 Enrollment ID: I20100524000036 |
Provider Name | Jennifer L Schoening |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1679539589 PECOS PAC ID: 9032119334 Enrollment ID: I20100527000371 |
Provider Name | Lori A King |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1548210925 PECOS PAC ID: 8123157005 Enrollment ID: I20100602000813 |
Provider Name | Kimberly A Romenesko |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1023368727 PECOS PAC ID: 8820247778 Enrollment ID: I20121009000443 |
Provider Name | Ryan R Chadek |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1902150964 PECOS PAC ID: 4789836545 Enrollment ID: I20121201000031 |
Provider Name | Evelina P Todd |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1346739414 PECOS PAC ID: 2062811292 Enrollment ID: I20210712003431 |
Ascension Medical Group Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2601 Fieldcrest Dr, Kaukauna, WI 54130 Phone: 920-462-6100 | |
Novacare Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 120 E 2nd St, Kaukauna, WI 54130 Phone: 920-737-6475 Fax: 920-766-8088 |