KENOSHA COMMUNITY HEALTH CENTER, INC.
NPI 1215823406
Clinic/Center - Federally Qualified Health Center (FQHC) in Racine, WI

Active since June 16, 2025CLIA 52D2259362 · Waiver
930 DR MARTIN LUTHER KING DR # 3, RACINE, WI 53404(262) 656-0044(262) 764-3636 Get Directions Write a Review

NPPES record last updated: February 25, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Kenosha Community Health Center, Inc. NPPES

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

KENOSHA COMMUNITY HEALTH CENTER, INC. (NPI 1215823406) is a healthcare organization registered as a federally qualified health center (fqhc) in Racine, Wisconsin and active in the NPI registry since June 2025. The organization holds a CLIA Waiver certificate valid through February 8, 2027 and lists John William Stampfl, Cfo, as its authorized official.

NPPES Registry Identity

NPI1215823406
Entity TypeOrganization
Primary Taxonomy261QF0400X
Legal Business NameKENOSHA COMMUNITY HEALTH CENTER, INC.
Location Address930 DR MARTIN LUTHER KING DR # 3Racine, WI 53404-3008
Mailing Address4006 Washington RdKenosha, WI 53144-4819 · (262) 771-3561 · Fax (262) 764-3636
Fax(262) 764-3636
Organization SubpartYes
Authorized OfficialJohn William StampflCfo · (262) 771-3561
Enumeration DateJune 16, 2025
Last NPPES UpdateFebruary 25, 2026
NPPES CertifiedFebruary 25, 2026
NPI 1215823406 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

Primary SpecialtyClinic/Center · Federally Qualified Health Center (FQHC)Ambulatory Health Care Facilities
Taxonomy Code261QF0400X
Also ListedFamily MedicineTaxonomy 207Q00000X
Also ListedNurse Practitioner · PediatricsTaxonomy 363LP0200X
930 DR MARTIN LUTHER KING DR # 3, Racine, WI 53404

Other Identifiers 1

Medicaid100328514WI

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

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 52D2259362

Kenosha Community Health Center, Inc Dba Pillar Health · Kenosha, WI
Active · expires Feb 8, 2027
CLIA Number52D2259362
Laboratory TypeFederally Qualified Health Center
Certificate Effective DateFebruary 9, 2025
Certificate Expiration DateFebruary 8, 2027
Laboratory DirectorDr. Timothy Sanborn
Laboratory Phone(262) 771-3500
Laboratory LocationKenosha Community Health Center, Inc Dba Pillar Health4006 Washington Rd, Kenosha, WI 53144
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

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

Nurse Practitioner (Pediatrics)
930 DR MARTIN LUTHER KING DR # 3
RACINE, WI 53404

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 Kenosha Community Health Center, Inc.'s NPI number?

The NPI number for Kenosha Community Health Center, Inc. is 1215823406. It was assigned to this organization in the NPPES registry on June 16, 2025.

Where is Kenosha Community Health Center, Inc. located?

Kenosha Community Health Center, Inc. is located at 930 Dr Martin Luther King Dr # 3, Racine, WI 53404. The listed phone number is (262) 656-0044.

What is Kenosha Community Health Center, Inc.'s specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Federally Qualified Health Center (FQHC), with taxonomy code 261QF0400X.

Does Kenosha Community Health Center, Inc. hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 52D2259362) is associated with this NPI, valid through February 8, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Kenosha Community Health Center, Inc. was last updated on February 25, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 months 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.