GREEN BAY CARDIOTHORACIC & VASCULAR, LLC
NPI 1538306410
Thoracic Surgery (Cardiothoracic Vascular Surgery) in Iron Mountain, MI
NPI Status: Active since January 14, 2009
Contact Information
1711 S STEPHENSON AVE
IRON MOUNTAIN, MI
ZIP 49801
Phone: (920) 433-9621
Fax: (920) 433-0565
- Organization
- Thoracic Surgery (Cardiothoracic Vascula...
- CLIA Number: 52D0866918
- CLIA Cert. Type: Ambulance
- CLIA Exp. Date: 08-31-2026
About GREEN BAY CARDIOTHORACIC & VASCULAR, LLC
This page provides the complete NPI Profile along with additional information for Green Bay Cardiothoracic & Vascular, Llc, a provider established in Iron Mountain, Michigan operating as a Thoracic Surgery (cardiothoracic Vascular Surgery). The healthcare provider is registered in the NPI registry with number 1538306410 assigned on January 2009. The practitioner's primary taxonomy code is 208G00000X. The provider is registered as an organization and their NPI record was last updated 17 years ago. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The authorized official of this NPI record is Mary Jo Holewinski (Office Manager)
- NPI
- 1538306410
- Provider Name
- GREEN BAY CARDIOTHORACIC & VASCULAR, LLC
- Entity Type
- Organization
- Location Address
- 1711 S STEPHENSON AVE IRON MOUNTAIN, MI 49801
- Location Phone
- (920) 433-9621
- Location Fax
- (920) 433-0565
- Mailing Address
- 720 S VANBUREN STREET SUITE 303 GREEN BAY, WI 54301
- Mailing Phone
- (920) 433-9621
- Mailing Fax
- (920) 433-0565
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 01-14-2009
- Last Update Date
- 01-16-2009
- Code Navigator
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
Thoracic Surgery (Cardiothoracic Vascular Surgery)
- Taxonomy Code
- 208G00000X
- Type
- Allopathic & Osteopathic Physicians
- Taxonomy Description
- A thoracic surgeon provides the operative, perioperative and critical care of patients with pathologic conditions within the chest. Included is the surgical care of coronary artery disease, cancers of the lung, esophagus and chest wall, abnormalities of the trachea, abnormalities of the great vessels and heart valves, congenital anomalies, tumors of the mediastinum and diseases of the diaphragm. The management of the airway and injuries of the chest is within the scope of the specialty.
Group Taxonomy 193400000X SINGLE SPECIALTY GROUP
This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
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.
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 |
|---|---|---|---|
| 32897600 | MEDICAID (05) | WI | |
| 1659412401 | OTHER (01) | WI | MEDICARE NPI |
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
- 52D0866918
- Facility Type
- Ambulance
- Certificate Effective Date
- September 01, 2024
- Certificate Expiration Date
- August 31, 2026
- Laboratory Director
- MR. RYAN GIBBONS
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Green Bay Cardiothoracic & Vascular, Llc 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 1538306410, 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.
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.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
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.
Other Providers at the Same Location
The following 20 providers are registered at the same or a nearby location.
IRON MOUNTAIN, MI 49801
IRON MOUNTAIN, MI 49801
IRON MOUNTAIN, MI 49801
IRON MOUNTAIN, MI 49801
IRON MOUNTAIN, MI 49801
IRON MOUNTAIN, MI 49801
IRON MOUNTAIN, MI 49801
IRON MOUNTAIN, MI 49801
IRON MOUNTAIN, MI 49801
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1538306410, enumerated as an "organization" on January 14, 2009.
The provider is located at 1711 S STEPHENSON AVE IRON MOUNTAIN, MI 49801 and the phone number is (920) 433-9621.
Thoracic Surgery (Cardiothoracic Vascular Surgery) with taxonomy code 208G00000X.
The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.
