Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Kenosha Community Health Center, Inc

Organization Family Medicine Physician · NPI 1215823406

Kenosha Community Health Center, Inc is a Family Medicine Physician in Racine, Wisconsin. Registered with an NPI since 2025.

In the registry since
2025
Specialties on file
3
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

930 Dr Martin Luther King Dr # 3
Racine, WI 53404-3008
Phone: (262) 656-0044
Fax: (262) 764-3636
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Federally Qualified Health Center (FQHC) (primary) Taxonomy 261QF0400X
Family Medicine Physician Taxonomy 207Q00000X
Pediatric Nurse Practitioner Taxonomy 363LP0200X

Record details

NPI number1215823406
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationKenosha Community Health Center, Inc
Authorized official John Stampfl — Cfo · (262) 771-3561
NPI enumeratedJune 16, 2025
Last updated in NPPESFebruary 25, 2026
Certification dateFebruary 25, 2026
Mailing address4006 Washington Rd, Kenosha, WI 53144-4819

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