OrganizationActive
Space Coast Family Practice
NPI 1811099054 · Clinic/Center · Green Bay, WI
Space Coast Family Practice is a Clinic/Center organization in Green Bay, WI (NPI 1811099054).
Provider details
- NPI number
- 1811099054
- Entity type
- Organization
- Primary specialty
- Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Thomas Betka, President(920) 544-5868
- License
- ME88311 (FL)
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
Detailed profile(90/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
3067 Windland Dr
Green Bay, WI 54311-7574
Phone: (920) 544-5868
Street-level locationGet directions
Mailing address
3067 Windland Dr
Green Bay, WI 54311-7574
Registry dates
- Enumerated
- 2006-09-01
- Last updated
- 2020-08-22
Frequently asked questions
- What is Space Coast Family Practice's NPI number?
- Space Coast Family Practice's National Provider Identifier (NPI) is 1811099054, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Space Coast Family Practice?
- Space Coast Family Practice is classified in the NPPES registry as Clinic/Center (Ambulatory Health Care Facilities).
- Where is Space Coast Family Practice located?
- Space Coast Family Practice's practice location on file with NPPES is 3067 Windland Dr, Green Bay, WI 54311-7574.
- What is Space Coast Family Practice's phone number?
- The practice phone number listed in the NPPES registry for Space Coast Family Practice is (920) 544-5868.
- Who is the authorized official for Space Coast Family Practice?
- The authorized official listed on Space Coast Family Practice's NPPES record is Thomas Betka, President. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Space Coast Family Practice's NPI active?
- Yes — Space Coast Family Practice's NPI (1811099054) is active in the NPPES registry as of the last update on 2020-08-22.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.