KENOSHA COMMUNITY HEALTH CENTER, INC.
NPI 1265435960
Clinic/Center - Federally Qualified Health Center (FQHC) in Kenosha, WI

NPI Status: Active since May 27, 2005

Contact Information

4536 22ND AVE
KENOSHA, WI
ZIP 53140
Phone: (262) 656-0044
Fax: (262) 653-2218

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  • Organization
  • Clinic/Center
  • Federally Qualified Health Center (FQHC)
  • Accepts Insurance
  • CLIA Number: 52D0909220
  • CLIA Cert. Type: Federally Qualified Health Center
  • CLIA Exp. Date: 05-17-2027

About KENOSHA COMMUNITY HEALTH CENTER, INC.

This page provides the complete NPI Profile along with additional information for Kenosha Community Health Center, Inc., a primary care provider established in Kenosha, Wisconsin operating as a Clinic/center, focusing in federally qualified health center (fqhc) . The healthcare provider is registered in the NPI registry with number 1265435960 assigned on May 2005. The practitioner's primary taxonomy code is 261QF0400X with license number NONE (WI). The provider is registered as an organization and their NPI record was last updated February 2026. Kenosha Community Health Center, Inc. operates as a Multi-Specialty Group with one or more individual practitioners, who practice different areas of specialization. The authorized official of this NPI record is Mary Elizabeth Ouimet (Ceo)

NPI
1265435960
Provider Name
KENOSHA COMMUNITY HEALTH CENTER, INC.
Entity Type
Organization
Location Address
4536 22ND AVE KENOSHA, WI 53140
Location Phone
(262) 656-0044
Location Fax
(262) 653-2218
Mailing Address
4006 WASHINGTON RD KENOSHA, WI 53144
Mailing Phone
(262) 656-0044
Mailing Fax
(262) 653-2218
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
05-27-2005
Last Update Date
02-25-2026
Code Navigator

A primary care provider (PCP) like Kenosha Community Health Center, Inc. sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc .

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 Federally Qualified Health Center (FQHC)

Taxonomy Code
261QF0400X
Type
Ambulatory Health Care Facilities
License No.
NONE
License State
WI

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1101Y00000XBehavioral Health & Social Service Providers

Counselor

 
2101YM0800XBehavioral Health & Social Service Providers

Counselor
Mental Health

 
3101YP2500XBehavioral Health & Social Service Providers

Counselor
Professional

 
41041C0700XBehavioral Health & Social Service Providers

Social Worker
Clinical

 
5122300000XDental Providers

Dentist

 
6207Q00000XAllopathic & Osteopathic Physicians

Family Medicine

 
72084P0800XAllopathic & Osteopathic Physicians

Psychiatry & Neurology
Psychiatry

 
82084P0804XAllopathic & Osteopathic Physicians

Psychiatry & Neurology
Child & Adolescent Psychiatry

 
9208D00000XAllopathic & Osteopathic Physicians

General Practice

 
10363LP0808XPhysician Assistants & Advanced Practice Nursing Providers

Nurse Practitioner
Psychiatric/Mental Health

 

Group Taxonomy 193200000X MULTI-SPECIALTY GROUP

This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Anthem Bronze Pathway/Lean 5000 (3 Free PCP Visits + $0 Select Drugs + Incentives) - HMO
  • Anthem Bronze Pathway/Lean HSA (+ Incentives) - HMO
  • Anthem Bronze Pathway/Lean Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
  • Anthem Bronze Preferred/Broad 5000 (3 Free PCP Visits + $0 Select Drugs + Incentives) - POS
  • Anthem Bronze Preferred/Broad HSA (+ Incentives) - POS
  • Anthem Bronze Preferred/Broad Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
  • Anthem Gold Pathway/Lean 1000 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
  • Anthem Gold Pathway/Lean Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
  • Anthem Gold Preferred/Broad 1000 ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
  • Anthem Gold Preferred/Broad Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
  • Anthem Heart Healthy Bronze Pathway/Lean 0 Med Ded ($0 Virtual PCP+$0 Select Drugs+Incentives) - HMO
  • Anthem Heart Healthy Bronze Preferred/Broad 0 Med Ded ($0 Virtual PCP+$0 Select Drugs+Incentives) - POS
  • Anthem Silver Pathway/Lean 4000 ($0 PCP Visits + $0 Select Drugs + Incentives) - HMO
  • Anthem Silver Pathway/Lean 5500 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
  • Anthem Silver Pathway/Lean Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
  • Anthem Silver Preferred/Broad 4000 ($0 PCP Visits + $0 Select Drugs + Incentives) - POS
  • Anthem Silver Preferred/Broad 5500 ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
  • Anthem Silver Preferred/Broad Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
  • CareSource (Common Ground Healthcare) Bronze $0 Ded / $2500 Rx Ded - EPO
  • CareSource (Common Ground Healthcare) Bronze $0 Ded / $2500 Rx Ded - Vision Exam - EPO
  • CareSource (Common Ground Healthcare) Bronze $9600 ($45 PCP Copay) - EPO
  • CareSource (Common Ground Healthcare) Bronze $9600 ($45 PCP Copay) - Vision Exam - EPO
  • CareSource (Common Ground Healthcare) Bronze Standard $7500 - EPO
  • CareSource (Common Ground Healthcare) Bronze Standard $7500 - Vision Exam - EPO
  • CareSource (Common Ground Healthcare) Gold $0 Ded - EPO
  • CareSource (Common Ground Healthcare) Gold $0 Ded - Vision Exam - EPO
  • CareSource (Common Ground Healthcare) Gold $3300 - EPO
  • CareSource (Common Ground Healthcare) Gold $3300 - Vision Exam - EPO
  • CareSource (Common Ground Healthcare) Gold Standard $2000 - EPO
  • CareSource (Common Ground Healthcare) Gold Standard $2000 - Vision Exam - EPO
  • CareSource (Common Ground Healthcare) Silver $4700 Ded / $5000 Rx Ded - EPO
  • CareSource (Common Ground Healthcare) Silver $4700 Ded / $5000 Rx Ded - Vision Exam - EPO
  • CareSource (Common Ground Healthcare) Silver $5000 Ded / $6000 Rx Ded - EPO
  • CareSource (Common Ground Healthcare) Silver $5000 Ded / $6000 Rx Ded - Vision Exam - EPO
  • CareSource (Common Ground Healthcare) Silver Standard $6000 - EPO
  • CareSource (Common Ground Healthcare) Silver Standard $6000 - Vision Exam - EPO

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.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

MARY ELIZABETH OUIMET

Authorized Official Title
CEO
Authorized Official Phone
(262) 771-3561

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
32956300MEDICAID (05)WI 

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
52D0909220
Facility Type
Federally Qualified Health Center
Certificate Effective Date
May 18, 2025
Certificate Expiration Date
May 17, 2027
Laboratory Director
DR. TIMOTHY SANBORN
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Kenosha Community Health Center, Inc. to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

Reviews for KENOSHA COMMUNITY HEALTH CENTER, INC.

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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 1265435960, we treat the final digit (0) 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 60. The final step is to find the difference between that total and the next multiple of ten (60 - 60 = 0).

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.

Pos 1
1
Doubled → 2
Pos 2
2
Unchanged
Pos 3
6
Doubled → 12 → 1 + 2
Pos 4
5
Unchanged
Pos 5
4
Doubled → 8
Pos 6
3
Unchanged
Pos 7
5
Doubled → 10 → 1 + 0
Pos 8
9
Unchanged
Pos 9
6
Doubled → 12 → 1 + 2
Check
0
Target digit
Regular digit Doubled digit Check digit

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.

1 → 2 6 → 12 → 3 4 → 8 5 → 10 → 1 6 → 12 → 3

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 2 + 1 + 2 + 5 + 8 + 3 + 1 + 0 + 9 + 1 + 2 + 24 = 60

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 60 is 60. The difference is the calculated check digit.

60 - 60 = 0
This NPI is valid
The calculated check digit is 0, which matches the last digit of 1265435960.

Other Providers at the Same Location


The following 20 providers are registered at the same or a nearby location.

Dentist (General Practice)
4536 22ND AVE
KENOSHA, WI 53140
Dentist (General Practice)
4536 22ND AVE
KENOSHA, WI 53140
Dentist (Pediatric Dentistry)
4536 22ND AVE
KENOSHA, WI 53140
Dental Hygienist
4536 22ND AVE
KENOSHA, WI 53140
Dental Hygienist
4536 22ND AVE
KENOSHA, WI 53140
Dental Hygienist
4536 22ND AVE
KENOSHA, WI 53140
Dental Hygienist
4536 22ND AVE
KENOSHA, WI 53140
Dental Hygienist
4536 22ND AVE
KENOSHA, WI 53140
Dental Hygienist
4536 22ND AVE
KENOSHA, WI 53140
Dietitian, Registered
4536 22ND AVE
KENOSHA, WI 53140
Social Worker (Clinical)
4536 22ND AVE
KENOSHA, WI 53140
Psychologist
4536 22ND AVE
KENOSHA, WI 53140
Psychologist (Clinical)
4536 22ND AVE
KENOSHA, WI 53140
Counselor (Professional)
4536 22ND AVE
KENOSHA, WI 53140
Counselor (Professional)
4536 22ND AVE
KENOSHA, WI 53140
Nurse Practitioner (Family)
4536 22ND AVE
KENOSHA, WI 53140
Nurse Practitioner (Family)
4536 22ND AVE
KENOSHA, WI 53140
Dentist (General Practice)
4536 22ND AVE
KENOSHA, WI 53140
Nurse Practitioner (Family)
4536 22ND AVE
KENOSHA, WI 53140
Pediatrics
4536 22ND AVE
KENOSHA, WI 53140

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1265435960, enumerated as an "organization" on May 27, 2005.

The provider is located at 4536 22ND AVE KENOSHA, WI 53140 and the phone number is (262) 656-0044.

Clinic/Center with taxonomy code 261QF0400X and a focus in Federally Qualified Health Center (FQHC).

The provider might be accepting Accepts: Anthem Blue Cross and Blue Shield, CareSource. Please consult your insurance carrier or call the provider to verify.