PREMISE HEALTH OF WISCONSIN MEDICAL SC
NPI 1760109052
Clinic/Center - Multi-Specialty in Kenosha, WI
About Premise Health Of Wisconsin Medical Sc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
PREMISE HEALTH OF WISCONSIN MEDICAL SC (NPI 1760109052), doing business as City Of Kenosha Wellness Center, is a healthcare organization registered as a multi-specialty in Kenosha, Wisconsin and active in the NPI registry since October 2022. The organization holds a CLIA Waiver certificate valid through February 1, 2027 and lists Edward William Schwartz, President, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
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 52D2276107
Premise Health Of Wisconsin Medical, Sc · Kenosha, WIOther Providers at the Same Location NPPES 2
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
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 Premise Health Of Wisconsin Medical Sc's NPI number?
The NPI number for Premise Health Of Wisconsin Medical Sc is 1760109052. It was assigned to this organization in the NPPES registry on October 26, 2022. The provider is doing business as City of Kenosha Wellness Center.
Where is Premise Health Of Wisconsin Medical Sc located?
Premise Health Of Wisconsin Medical Sc is located at 4303 39th Ave, Kenosha, WI 53144. The listed phone number is (262) 653-4444.
What is Premise Health Of Wisconsin Medical Sc's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Multi-Specialty, with taxonomy code 261QM1300X.
Does Premise Health Of Wisconsin Medical Sc hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 52D2276107) is associated with this NPI, valid through February 1, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
When was this NPI record last updated?
The NPPES record for Premise Health Of Wisconsin Medical Sc was last updated on February 17, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 months 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.
# Premise Health Of Wisconsin Medical Sc · NPI 1760109052
Multi-Specialty organization in Kenosha, Wisconsin. Organization record, active in the CMS NPPES registry since October 26, 2022.
## Identity
- **NPI:** 1760109052 (Entity type: Organization)
- **Enumerated:** October 26, 2022
- **Primary specialty:** Clinic/Center - Multi-Specialty · taxonomy 261QM1300X
- **Also known as:** City of Kenosha Wellness Center (Doing Business As)
- **Organization subpart:** No
- **Authorized official:** Edward Schwartz, PRESIDENT
## Practice location
- **Address:** 4303 39TH AVE, Kenosha, WI 53144-1969
- **Phone:** (262) 653-4444
## Record status
- **NPPES last updated:** February 17, 2026
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1760109052) · Data from the CMS NPPES public registry.