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DOUSMAN CLINIC, S.C.
NPI 1265634331
Family Medicine in Green Bay, WI

Active since June 01, 2007CLIA 52D0395048 · Waiver
124 SIEGLER ST, GREEN BAY, WI 54303(920) 494-9661 Get Directions Write a Review

NPPES record last updated: October 24, 2012. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dousman Clinic, S.c. NPPES

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

DOUSMAN CLINIC, S.C. (NPI 1265634331) is a healthcare organization registered as a family medicine in Green Bay, Wisconsin and active in the NPI registry since June 2007. The organization holds a CLIA Waiver certificate valid through January 23, 2027 and lists Jan E Reimer, Clinic Manager, as its authorized official.

NPPES Registry Identity

NPI1265634331
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameDOUSMAN CLINIC, S.C.
Location Address124 SIEGLER STGreen Bay, WI 54303-2636
Mailing Address124 Siegler StGreen Bay, WI 54303-2636 · (920) 494-9661
Phone(920) 494-9661
Organization SubpartNo
Authorized OfficialJan E ReimerClinic Manager · (920) 494-9661
Enumeration DateJune 1, 2007
Last NPPES UpdateOctober 24, 2012
✔ NPI 1265634331 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
124 SIEGLER ST, Green Bay, WI 54303
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Other Identifiers 2

Medicare ID-Type Unspecified000007695WI
Medicaid32786100WI

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, CareSource (Common Ground Healthcare).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 52D0395048

Dousman Clinic Sc · Green Bay, WI
Active · expires Jan 23, 2027
CLIA Number52D0395048
Laboratory TypePhysician Office
Certificate Effective DateJanuary 24, 2025
Certificate Expiration DateJanuary 23, 2027
Laboratory DirectorDr. Mark Jenson
Laboratory Phone(920) 494-9661
Laboratory LocationDousman Clinic Sc124 Siegler St, Green Bay, WI 54303
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 4

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

MATTHEW KRUEGER JENSON MD
Family Medicine
124 SIEGLER ST
GREEN BAY, WI 54303
Brown County (920) 494-9661
DR. LLOYD CHARLES CASSIDY IV MD
Family Medicine
124 SIEGLER ST
GREEN BAY, WI 54303
Brown County (920) 605-3115
MARK K JENSON M.D.
Family Medicine
124 SIEGLER ST
GREEN BAY, WI 54303
Brown County (920) 494-9661
BELLIN MEMORIAL HOSPITAL INC
Pediatrics
124 SIEGLER ST
GREEN BAY, WI 54303
Brown County (920) 497-7771

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 Dousman Clinic, S.C.'s NPI number?

The NPI number for Dousman Clinic, S.C. is 1265634331. It was assigned to this organization in the NPPES registry on June 1, 2007.

Where is Dousman Clinic, S.C. located?

Dousman Clinic, S.C. is located at 124 Siegler St, Green Bay, WI 54303. The listed phone number is (920) 494-9661.

What is Dousman Clinic, S.C.'s specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Does Dousman Clinic, S.C. hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 52D0395048) is associated with this NPI, valid through January 23, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Dousman Clinic, S.C. accept?

Health plans from Anthem Blue Cross and Blue Shield and CareSource (Common Ground Healthcare) list Dousman Clinic, S.C. 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 Dousman Clinic, S.C. was last updated on October 24, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.