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ST GIANNA MOLLA CLINIC, INC
NPI 1104426477
Clinic/Center - Multi-Specialty in De Pere, WI

Active since October 27, 2020CLIA 52D2213189 · Waiver
1716 LAWRENCE DR STE 100, DE PERE, WI 54115(920) 605-3115(920) 486-6826 Get Directions Write a Review

NPPES record last updated: April 5, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Apr 5, 2023, Dec 21, 2021, Feb 22, 2021 and 1 more (4 updates tracked since 2020).

About St Gianna Molla Clinic, Inc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ST GIANNA MOLLA CLINIC, INC (NPI 1104426477) is a healthcare organization registered as a multi-specialty in De Pere, Wisconsin and active in the NPI registry since October 2020. The organization holds a CLIA Waiver certificate valid through February 9, 2027 and lists Robin Goldsmith, President/chief Medical Officer, as its authorized official.

NPPES Registry Identity

NPI1104426477
Entity TypeOrganization
Primary Taxonomy261QM1300X
Legal Business NameST GIANNA MOLLA CLINIC, INC
Location Address1716 LAWRENCE DR STE 100De Pere, WI 54115-9108
Mailing Address1716 Lawrence Dr Ste 100De Pere, WI 54115-9108 · (920) 605-3115 · Fax (920) 486-6826
Phone(920) 605-3115
Fax(920) 486-6826
Organization SubpartNo
Authorized OfficialRobin GoldsmithPresident/chief Medical Officer · (920) 716-1451
Enumeration DateOctober 27, 2020
Last NPPES UpdateApril 5, 20234 updates tracked since enumeration
NPPES CertifiedApril 5, 2023
✔ NPI 1104426477 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyClinic/Center · Multi-SpecialtyAmbulatory Health Care Facilities
Taxonomy Code261QM1300X
Also ListedFamily MedicineTaxonomy 207Q00000X
Also ListedObstetrics & GynecologyTaxonomy 207V00000X
1716 LAWRENCE DR STE 100, De Pere, WI 54115
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Other Identifiers 1

Medicaid100163645WI

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, HealthPartners.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 52D2213189

St Gianna Clinics · De Pere, WI
Active · expires Feb 9, 2027
CLIA Number52D2213189
Laboratory TypePhysician Office
Certificate Effective DateFebruary 10, 2025
Certificate Expiration DateFebruary 9, 2027
Laboratory DirectorDr. Robin Goldsmith
Laboratory Phone(920) 605-3115
Laboratory LocationSt Gianna Clinics1716 Lawrence Drive Ste 100, De Pere, WI 54115
CLIA data matches this NPI record on: Address Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

THOMAS E REINARDY MD
Obstetrics & Gynecology
1716 LAWRENCE DR STE 100
DE PERE, WI 54115
Brown County (920) 605-3115
DR. MADELEINE NERI GUEVARA D.O.
Obstetrics & Gynecology (Obstetrics)
1716 LAWRENCE DR STE 100
DE PERE, WI 54115
Brown County (920) 605-3115
DR. ANDREA Q TALEON MD
Pediatrics
1716 LAWRENCE DR STE 100
DE PERE, WI 54115
Brown County (920) 605-3115
DR. ROBERT JAMES RUCINSKI M.D.
Psychiatry & Neurology (Psychiatry)
1716 LAWRENCE DR STE 100
DE PERE, WI 54115
Brown County (920) 605-3115
DR. BRIANNA KLOTZ DNP, APNP, FNP-BC
Nurse Practitioner (Family)
1716 LAWRENCE DR STE 100
DE PERE, WI 54115
Brown County (920) 605-3115

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is St Gianna Molla Clinic, Inc's NPI number?

The NPI number for St Gianna Molla Clinic, Inc is 1104426477. It was assigned to this organization in the NPPES registry on October 27, 2020.

Where is St Gianna Molla Clinic, Inc located?

St Gianna Molla Clinic, Inc is located at 1716 Lawrence Dr Ste 100, De Pere, WI 54115. The listed phone number is (920) 605-3115.

What is St Gianna Molla Clinic, Inc's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Multi-Specialty, with taxonomy code 261QM1300X.

Does St Gianna Molla Clinic, Inc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 52D2213189) is associated with this NPI, valid through February 9, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does St Gianna Molla Clinic, Inc accept?

Health plans from Anthem Blue Cross and Blue Shield and HealthPartners list St Gianna Molla Clinic, Inc as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for St Gianna Molla Clinic, Inc was last updated on April 5, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.