OB-GYN ASSOC OF GREEN BAY LTD NPI 1154400034

NPI Information

  • NPI: 1154400034
  • Provider Name: OB-GYN ASSOC OF GREEN BAY LTD
  • Classification: Obstetrics & Gynecology - 207VC0200X
  • Specialization: Critical Care Medicine
  • Entity Type: Organization
  • Address: 704 S WEBSTER AVE
    STE 300
    GREEN BAY, WI
    ZIP 54301
  • Phone: (920) 468-3443

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NPI Details

OB-GYN ASSOC OF GREEN BAY LTD is a critical care medicine obstetrics gynecology in Green Bay, WI. The provider is an obstetrician/gynecologist, who specializes in critical care medicine diagnoses, treats and supports female patients with multiple organ dysfunction. This specialist may have administrative responsibilities for intensive care units and may also facilitate and coordinate patient care among the primary physician, the critical care staff and other specialists. OB-GYN ASSOC OF GREEN BAY LTD NPI is 1154400034. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

704 S WEBSTER AVE
STE 300
GREEN BAY, WI
ZIP 54301
Phone: (920) 468-3443
Fax: (920) 432-6313

The provider's authorized official is Robert Knox Demott .
The authorized official title is Owner Operator and has the following contact phone number (920) 468-3443.

The enumeration date for this NPI number is 11/3/2006 and was last updated on 7/1/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1364SF0001XClinical Nurse SpecialistFamily HealthWISCONSINNo
2207VC0200XObstetrics & GynecologyCritical Care MedicineWISCONSINYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1P73556MEDICARE UPIN
2P73676MEDICARE UPIN
343977500MEDICAIDWISCONSIN
4C89528MEDICARE UPIN
552388MEDICARE UPIN
641964300MEDICAIDWISCONSIN
7G16487MEDICARE UPIN
8B56278MEDICARE UPIN
9P73555MEDICARE UPIN
1030661000MEDICAIDWISCONSIN
1141963900MEDICAIDWISCONSIN
1232400300MEDICAIDWISCONSIN
1330984300MEDICAIDWISCONSIN
141174547244OTHERKIM SHEFCHIK PAC NPI

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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