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GREEN LAKE MEDICAL CLINIC , S.C.
NPI 1306986716
Family Medicine in Green Lake, WI

Active since February 07, 2007
N6205 BUSSE DRIVE, GREEN LAKE, WI 54941(920) 294-3444(920) 294-6660 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Green Lake Medical Clinic , S.c. NPPES

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

GREEN LAKE MEDICAL CLINIC , S.C. (NPI 1306986716) is a healthcare organization registered as a family medicine in Green Lake, Wisconsin and active in the NPI registry since February 2007. The organization lists Thomas Rice Willett, President, as its authorized official.

NPPES Registry Identity

NPI1306986716
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameGREEN LAKE MEDICAL CLINIC , S.C.
Location AddressN6205 BUSSE DRIVEGreen Lake, WI 54941
Mailing AddressN6205 Busse Drive, Po Box 429Green Lake, WI 54941 · (920) 294-3444 · Fax (920) 294-6660
Phone(920) 294-3444
Fax(920) 294-6660
Organization SubpartNo
Authorized OfficialThomas Rice WillettPresident · (920) 294-3444
Enumeration DateFebruary 7, 2007
Last NPPES UpdateAugust 22, 2020
✔ NPI 1306986716 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in WI · 17659
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.
N6205 BUSSE DRIVE, Green Lake, WI 54941
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Other Identifiers 1

Medicaid30071600WI

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 Quartz.Insurance ›

Other Providers at the Same Location NPPES

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

GREEN LAKE MEDICAL CLINIC
Clinical Medical Laboratory
N6205 BUSSE DRIVE
GREEN LAKE, WI 54941
Green Lake County (920) 294-3444

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 Green Lake Medical Clinic , S.C.'s NPI number?

The NPI number for Green Lake Medical Clinic , S.C. is 1306986716. It was assigned to this organization in the NPPES registry on February 7, 2007.

Where is Green Lake Medical Clinic , S.C. located?

Green Lake Medical Clinic , S.C. is located at N6205 Busse Drive, Green Lake, WI 54941. The listed phone number is (920) 294-3444.

What is Green Lake Medical Clinic , S.C.'s specialty?

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

What insurance does Green Lake Medical Clinic , S.C. accept?

Health plans from Quartz list Green Lake Medical 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 Green Lake Medical Clinic , S.C. was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.