KEWASKUM CLINIC
NPI 1518976919
Family Medicine in Kewaskum, WI

Q: What is West Bend Clinic's NPI number?

The NPI number for West Bend Clinic is 1518976919. It was assigned to this organization in the NPPES registry on August 5, 2006. The provider is also known as Kewaskum Clinic.

Q: What is West Bend Clinic's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for West Bend Clinic was last updated on May 23, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.

Active since August 05, 2006

1701 FOND DU LAC AVE, KEWASKUM, WI 53040(262) 626-4616 Get Directions Write a Review

NPPES record last updated: May 23, 2012. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Kewaskum Clinic NPPES

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

KEWASKUM CLINIC (NPI 1518976919) is a healthcare organization registered as a family medicine in Kewaskum, Wisconsin and active in the NPI registry since August 2006. The organization lists Gregory G Blommel, Medical Director, as its authorized official.

NPPES Registry Identity

NPI1518976919

Entity TypeOrganization

Primary Taxonomy207Q00000X

Legal Business NameWEST BEND CLINIC

Location Address1701 FOND DU LAC AVEKewaskum, WI 53040-9129

Mailing Address1700 W Paradise DrWest Bend, WI 53095-9795 · (262) 334-3451

Phone(262) 626-4616

Organization SubpartNo

Authorized OfficialGregory G BlommelMedical Director · (262) 334-3451

Enumeration DateAugust 5, 2006

Last NPPES UpdateMay 23, 2012

✔ NPI 1518976919 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 5

★ 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.

Also ListedInternal MedicineTaxonomy 207R00000X

Also ListedPediatricsTaxonomy 208000000X

Also ListedRadiology · Body ImagingTaxonomy 2085B0100X

Also ListedDurable Medical Equipment & Medical SuppliesTaxonomy 332B00000X

1701 FOND DU LAC AVE, Kewaskum, WI 53040

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Other Names 1

Other NameKewaskum Clinic

Other Identifiers 2

Medicare ID-Type Unspecified67025WI · Group Number

Medicaid21251400WI

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

Other Providers at the Same Location NPPES 10

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

CHARLOTTE REBECCA RUTKOWSKI MD

Internal Medicine