FROEDTERT SOUTH INC. NPI 1558305284

NPI Information

  • NPI: 1558305284
  • Provider Name: FROEDTERT SOUTH, INC.
  • Classification: Family Medicine - 207Q00000X
  • Entity Type: Organization
  • Doing Business As: FROEDTERT SOUTH MEDICAL GROUP
  • Address: 6308 8TH AVE
    KENOSHA, WI
    ZIP 53143
  • Phone: (262) 656-2718

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NPI Details

FROEDTERT SOUTH, INC. is a family medicine in Kenosha, WI. The provider is 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. FROEDTERT SOUTH, INC. NPI is 1558305284. The provider is registered as an organization entity type.
The provider Is Doing Business As Froedtert South Medical Group.

The provider's business location address is:

6308 8TH AVE
KENOSHA, WI
ZIP 53143
Phone: (262) 656-2718

The provider's authorized official is Thomas J Kelley .
The authorized official title is Vice President & Cfo and has the following contact phone number (262) 577-8113.

The enumeration date for this NPI number is 6/15/2006 and was last updated on 3/15/2023.

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
1261Q00000XClinic/CenterNo
2261QM1300XClinic/CenterMulti-SpecialtyNo
3207Q00000XFamily MedicineYes

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
132815500MEDICAIDWISCONSIN
2CR0320OTHERWISCONSINMEDICARE RR
3213742OTHERILLINOISMEDICARE

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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