ROCK RIVER COMMUNITY CLINIC INC
NPI 1427717115
Clinic/Center - Federally Qualified Health Center (FQHC) in Watertown, WI

NPI Status: Active since December 10, 2021

Contact Information

132 HOSPITAL DR
WATERTOWN, WI
ZIP 53098
Phone: (920) 206-7797
Fax: (920) 206-0870

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  • Organization
  • Clinic/Center
  • Federally Qualified Health Center (FQHC)
  • Accepts Insurance
  • CLIA Number: 52D2312382
  • CLIA Cert. Type: Community Clinic
  • CLIA Exp. Date: 10-09-2026

About ROCK RIVER COMMUNITY CLINIC INC

This page provides the complete NPI Profile along with additional information for Rock River Community Clinic Inc, a primary care provider established in Watertown, Wisconsin operating as a Clinic/center, focusing in federally qualified health center (fqhc) . The healthcare provider is registered in the NPI registry with number 1427717115 assigned on December 2021. The practitioner's primary taxonomy code is 261QF0400X. The provider is registered as an organization and their NPI record was last updated one year ago. The provider's . The authorized official of this NPI record is Olivia Nichols Phd (Ceo/executive Director)

NPI
1427717115
Provider Legal Name
ROCK RIVER COMMUNITY CLINIC INC
Other Organization Name
Other Name Type
(6)
Entity Type
Organization
Location Address
132 HOSPITAL DR WATERTOWN, WI 53098
Location Phone
(920) 206-7797
Location Fax
(920) 206-0870
Mailing Address
1461 W MAIN ST WHITEWATER, WI 53190
Mailing Phone
(262) 472-6839
Is Sole Proprietor?
No
Is Organization Subpart?
Yes
Enumeration Date
12-10-2021
Last Update Date
06-02-2025
Code Navigator

A primary care provider (PCP) like Rock River Community Clinic 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

Secondary Locations

  • 415 S 8th St
    Watertown, WI 53094
    (920) 206-7797

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

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)
1261QC1500XAmbulatory Health Care Facilities

Clinic/Center
Community Health

 

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
  • QUARTZ GUNDERSEN PERFORMANCE BRONZE $0 MEDICAL DED - HMO
  • QUARTZ GUNDERSEN PERFORMANCE BRONZE $10,150 DED - HMO
  • QUARTZ GUNDERSEN PERFORMANCE BRONZE (DENTAL & VISION) $0 MEDICAL DED - HMO
  • QUARTZ GUNDERSEN PERFORMANCE BRONZE (DENTAL & VISION) $10,150 DED - HMO
  • QUARTZ GUNDERSEN PERFORMANCE BRONZE (DENTAL & VISION) STANDARD EASY PRICING - HMO
  • QUARTZ GUNDERSEN PERFORMANCE BRONZE STANDARD EASY PRICING - HMO
  • QUARTZ GUNDERSEN PERFORMANCE CATASTROPHIC $10,600 DED - HMO
  • QUARTZ GUNDERSEN PERFORMANCE GOLD $4,000 DED - HMO
  • QUARTZ GUNDERSEN PERFORMANCE GOLD (DENTAL & VISION) $4,000 DED - HMO
  • QUARTZ GUNDERSEN PERFORMANCE GOLD (DENTAL & VISION) STANDARD EASY PRICING - HMO
  • QUARTZ GUNDERSEN PERFORMANCE GOLD MAINTENANCE $700 DED - HMO
  • QUARTZ GUNDERSEN PERFORMANCE GOLD MAINTENANCE (DENTAL & VISION) $700 DED - HMO
  • QUARTZ GUNDERSEN PERFORMANCE GOLD STANDARD EASY PRICING - HMO
  • QUARTZ GUNDERSEN PERFORMANCE SILVER $8,000 DED - HMO
  • QUARTZ GUNDERSEN PERFORMANCE SILVER $9,000 DED - HMO
  • QUARTZ GUNDERSEN PERFORMANCE SILVER (DENTAL & VISION) $8,000 DED - HMO
  • QUARTZ GUNDERSEN PERFORMANCE SILVER (DENTAL & VISION) $9,000 DED - HMO
  • QUARTZ GUNDERSEN PERFORMANCE SILVER (DENTAL & VISION) STANDARD EASY PRICING - HMO
  • QUARTZ GUNDERSEN PERFORMANCE SILVER STANDARD EASY PRICING - HMO
  • QUARTZ ONE ACHIEVE W/GUNDERSEN BRONZE $0 MEDICAL DED - HMO

*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

OLIVIA NICHOLS PHD

Authorized Official Title
CEO/EXECUTIVE DIRECTOR
Authorized Official Phone
(262) 472-6839

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
52D2312382
Facility Type
Community Clinic
Certificate Effective Date
October 10, 2024
Certificate Expiration Date
October 09, 2026
Laboratory Director
DR. DONALD L. WILLIAMS
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Rock River Community Clinic 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.

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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 1427717115, we treat the final digit (5) 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 55. The final step is to find the difference between that total and the next multiple of ten (60 - 55 = 5).

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
4
Unchanged
Pos 3
2
Doubled → 4
Pos 4
7
Unchanged
Pos 5
7
Doubled → 14 → 1 + 4
Pos 6
1
Unchanged
Pos 7
7
Doubled → 14 → 1 + 4
Pos 8
1
Unchanged
Pos 9
1
Doubled → 2
Check
5
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 2 → 4 7 → 14 → 5 7 → 14 → 5 1 → 2

Step 2: Add all digits plus the NPI constant

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

2 + 4 + 4 + 7 + 1 + 4 + 1 + 1 + 4 + 1 + 2 + 24 = 55

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

The next multiple of ten after 55 is 60. The difference is the calculated check digit.

60 - 55 = 5
This NPI is valid
The calculated check digit is 5, which matches the last digit of 1427717115.

Other Providers at the Same Location


The following 6 providers are registered at the same or a nearby location.

Physician Assistant
132 HOSPITAL DR
WATERTOWN, WI 53098
Family Medicine
132 HOSPITAL DR
WATERTOWN, WI 53098
Physician Assistant
132 HOSPITAL DR
WATERTOWN, WI 53098
Family Medicine
132 HOSPITAL DR
WATERTOWN, WI 53098
Physician Assistant (Medical)
132 HOSPITAL DR
WATERTOWN, WI 53098
Family Medicine
132 HOSPITAL DR
WATERTOWN, WI 53098

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1427717115, enumerated as an "organization" on December 10, 2021.

The provider is located at 132 HOSPITAL DR WATERTOWN, WI 53098 and the phone number is (920) 206-7797.

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 and Quartz. Please consult your insurance carrier or call the provider to verify.