OrganizationActive
Kenosha Community Health Center, Inc.
NPI 1215823406 · Federally Qualified Health Center (FQHC) · Racine, WI
Provider details
- NPI number
- 1215823406
- Entity type
- Organization
- Primary specialty
- Federally Qualified Health Center (FQHC)Ambulatory Health Care Facilities
- Parent organization
- Kenosha Community Health Center, Inc.
- Organization subpart
- Yes
- Authorized official
- John Stampfl, Cfo(262) 771-3561
Specialties & taxonomies
Ambulatory Health Care Facilities
- Family Medicine Physician207Q00000X
Allopathic & Osteopathic Physicians
- Pediatric Nurse Practitioner363LP0200X
Physician Assistants & Advanced Practice Nursing Providers
Practice location
930 Dr Martin Luther King Dr # 3
Racine, WI 53404-3008
Phone: (262) 656-0044
Fax: (262) 764-3636
Approximate (ZIP-level) locationGet directions
Mailing address
4006 Washington Rd
Kenosha, WI 53144-4819
Registry dates
- Enumerated
- 2025-06-16
- Last updated
- 2026-02-25
- Certified
- 2026-02-25
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.