GREAT LAKES FAMILY MEDICAL CENTER INC
NPI 1093900136
Clinic/Center in Kenosha, WI
NPI Status: Active since September 12, 2007
Contact Information
6123 GREEN BAY RD
SUITE 120
KENOSHA, WI
ZIP 53142
Phone: (262) 764-4390
Fax: (262) 764-4396
- Organization
- Clinic/Center
About GREAT LAKES FAMILY MEDICAL CENTER INC
This page provides the complete NPI Profile along with additional information for Great Lakes Family Medical Center Inc, a provider established in Kenosha, Wisconsin operating as a Clinic/center. The healthcare provider is registered in the NPI registry with number 1093900136 assigned on September 2007. The practitioner's primary taxonomy code is 261Q00000X with license number 45606020 (WI). The provider is registered as an organization and their NPI record was last updated 16 years ago. The authorized official of this NPI record is Dr. Jawaid Quddus M.d., Ph.d. (President)
- NPI
- 1093900136
- Provider Name
- GREAT LAKES FAMILY MEDICAL CENTER INC
- Entity Type
- Organization
- Location Address
- 6123 GREEN BAY RD SUITE 120 KENOSHA, WI 53142
- Location Phone
- (262) 764-4390
- Location Fax
- (262) 764-4396
- Mailing Address
- 6123 GREEN BAY ROAD SUITE 120 KENOSHA, WI 53142
- Mailing Phone
- (262) 764-4390
- Mailing Fax
- (262) 764-4396
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 09-12-2007
- Last Update Date
- 08-26-2010
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Clinic/Center
- Taxonomy Code
- 261Q00000X
- Type
- Ambulatory Health Care Facilities
- License No.
- 45606020
- License State
- WI
- Taxonomy Description
- A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 34414100 | MEDICAID (05) | WI | |
| H91649 | MEDICARE UPIN (02) | WI | |
| 000032057 | MEDICARE PIN (08) | WI |
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1093900136, we treat the final digit (6) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 54. The final step is to find the difference between that total and the next multiple of ten (60 - 54 = 6).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 54 is 60. The difference is the calculated check digit.
Other Providers at the Same Location
The following 12 providers are registered at the same or a nearby location.
KENOSHA, WI 53142
KENOSHA, WI 53142
KENOSHA, WI 53142
KENOSHA, WI 53142
KENOSHA, WI 53142
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1093900136, enumerated as an "organization" on September 12, 2007.
The provider is located at 6123 GREEN BAY RD SUITE 120 KENOSHA, WI 53142 and the phone number is (262) 764-4390.
Clinic/Center with taxonomy code 261Q00000X.
The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.
