CH Specialty Services Wi SC - Medicare Primary Care in Hartford, WI

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CH Specialty Services Wi SC is a medicare enrolled primary clinic (Internal Medicine) in Hartford, Wisconsin. The current practice location for CH Specialty Services Wi SC is 1366 E Sumner St # 1002, Hartford, Wisconsin. For appointments, you can reach them via phone at (337) 408-0797. The mailing address for CH Specialty Services Wi SC is 5750 Johnston St Ste 205, Lafayette, Louisiana and phone number is (337) 408-0797.

CH Specialty Services Wi SC is licensed to practice in NU (license number ). The clinic also participates in the medicare program and its NPI number is 1063115319. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (337) 408-0797.

Contact Information

CH Specialty Services Wi SC
1366 E Sumner St # 1002
Hartford
WI 53027-1614
(337) 408-0797
Not Available

Map and Direction


Primary Care Clinic Profile

Full NameCH Specialty Services Wi SC
SpecialityInternal Medicine
Location1366 E Sumner St # 1002, Hartford, Wisconsin
Authorized Official Name and PositionNicole Howard (SR VP OF ADMINISTRATIVE SERVICES)
Authorized Official Contact3374080797
Accepts Medicare InsuranceYes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
CH Specialty Services Wi SC
5750 Johnston St Ste 205
Lafayette
LA 70503-5345

Ph: (337) 408-0797		CH Specialty Services Wi SC
1366 E Sumner St # 1002
Hartford
WI 53027-1614

Ph: (337) 408-0797

NPI Details:

NPI Number1063115319
Provider Enumeration Date03/24/2023
Last Update Date03/21/2025
Certification Date03/21/2025

Medicare PECOS Information:

Medicare PECOS PAC ID9234504820
Medicare Enrollment IDO20230413000664

Medical Identifiers

Medical identifiers for CH Specialty Services Wi SC such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1063115319NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207R00000XInternal Medicine (NU)Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. CH Specialty Services Wi SC acts as a billing entity for following providers:
Provider NameOrell R Williams
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1972559755
PECOS PAC ID: 3375511934
Enrollment ID: I20040921000930
Provider NameJonathan J Cotter
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1003989724
PECOS PAC ID: 8628008125
Enrollment ID: I20050815000720
Provider NameRyan D Holzmacher
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1598700601
PECOS PAC ID: 7214909761
Enrollment ID: I20060905000204
Provider NamePriya Asija
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1982817771
PECOS PAC ID: 8729188461
Enrollment ID: I20070711000355
Provider NameDebbra L Spexet
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1366460677
PECOS PAC ID: 7214956374
Enrollment ID: I20110302000104
Provider NameConstance L Cayer-wirtz
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1396036901
PECOS PAC ID: 6608044490
Enrollment ID: I20110721000736
Provider NameDaniel S Skeen
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1487942694
PECOS PAC ID: 6608046404
Enrollment ID: I20110906000343
Provider NameVeronica Rejon
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1497069231
PECOS PAC ID: 9032385026
Enrollment ID: I20111221000496
Provider NameAnne M Janning
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1417220021
PECOS PAC ID: 6406016930
Enrollment ID: I20120321000173
Provider NameCassandra J Daniels
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1902159825
PECOS PAC ID: 5890947832
Enrollment ID: I20121220000225
Provider NameRoxanne Grosskopf
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1417205451
PECOS PAC ID: 6901059617
Enrollment ID: I20130109000081
Provider NameElizabeth Haeger
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1033469242
PECOS PAC ID: 7719117548
Enrollment ID: I20140224000389
Provider NameKimberly Hand
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1033532510
PECOS PAC ID: 4688805047
Enrollment ID: I20140327001661
Provider NameChristine E Glen
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1356743892
PECOS PAC ID: 5799907200
Enrollment ID: I20141118002319
Provider NameMarci L Mcdonald
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1649427501
PECOS PAC ID: 9234454877
Enrollment ID: I20150203000192
Provider NameJill Marie Christie
Provider TypePractitioner - Physician Assistant
Provider IdentifiersNPI Number: 1790093367
PECOS PAC ID: 2365674710
Enrollment ID: I20151026001755
Provider NameTaha Y El-shahat
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1700225117
PECOS PAC ID: 4385937176
Enrollment ID: I20160802000478
Provider NameEric Dobbeck
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1144773607
PECOS PAC ID: 0840586095
Enrollment ID: I20160914001228
Provider NameLisa Draze
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1366814493
PECOS PAC ID: 7517243561
Enrollment ID: I20190226003220
Provider NameQurratulain Hayat
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1932582079
PECOS PAC ID: 4284982836
Enrollment ID: I20190523002317
Provider NameTiera Manuel
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1982203857
PECOS PAC ID: 5597173799
Enrollment ID: I20210427001927
Provider NameHallie Richards
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1063065274
PECOS PAC ID: 6002299971
Enrollment ID: I20220810003297
Provider NameBrian Cooper
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1366678963
PECOS PAC ID: 0547426223
Enrollment ID: I20230405002210
Provider NameBrian Whyms
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1821440066
PECOS PAC ID: 2365736378
Enrollment ID: I20230501002651
Provider NameSarah Rae Zarenana
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1467162016
PECOS PAC ID: 6709241276
Enrollment ID: I20230505001507
Provider NameAmelia J Miller
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1598455560
PECOS PAC ID: 4183084270
Enrollment ID: I20230720003936
Provider NameTasha Janssen
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1447808233
PECOS PAC ID: 1850621145
Enrollment ID: I20230728001012
Provider NameScott David Hellmich
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1568178341
PECOS PAC ID: 2264887561
Enrollment ID: I20231005003068
Provider NameBarbara a Bergstrom
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1093585549
PECOS PAC ID: 2961846985
Enrollment ID: I20240219000601
Provider NameRuth Seeley
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1295392421
PECOS PAC ID: 3779818737
Enrollment ID: I20240320003048
Provider NameJodi Wilson
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1861901555
PECOS PAC ID: 3971860180
Enrollment ID: I20240620003438
Provider NameShipeng Wei
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1023469798
PECOS PAC ID: 4789970179
Enrollment ID: I20240626001049
Provider NameChante Campbell-nixon
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1649868738
PECOS PAC ID: 7416361126
Enrollment ID: I20240626001268
Provider NameBridget Nore
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1306508262
PECOS PAC ID: 8426447988
Enrollment ID: I20240708000561
Provider NameDavid Colvin
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1023010592
PECOS PAC ID: 5496855793
Enrollment ID: I20240808003998
Provider NameLadonna Davis
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1649680984
PECOS PAC ID: 8123566437
Enrollment ID: I20240819000860
Provider NameKrista Pritchard
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1780203075
PECOS PAC ID: 7315343571
Enrollment ID: I20240819001045
Provider NameBrittany Enlow
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1114530045
PECOS PAC ID: 3072930155
Enrollment ID: I20240828003293
Provider NameCandace Eastman
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1073382065
PECOS PAC ID: 5698112670
Enrollment ID: I20240916003800
Provider NameEnleigh Dobyns-schuetter
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1649018805
PECOS PAC ID: 3870034291
Enrollment ID: I20240925000623
Provider NameAthena a Falkenthal
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1427886985
PECOS PAC ID: 8729519392
Enrollment ID: I20241007002601
Provider NameMariah Hanson
Provider TypePractitioner - Physician Assistant
Provider IdentifiersNPI Number: 1659890762
PECOS PAC ID: 2466711643
Enrollment ID: I20241120001154
Provider NameKaitlynn Mckay
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1124772546
PECOS PAC ID: 5890182901
Enrollment ID: I20241216000895
Provider NameAudrianna D Sparks
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1245766294
PECOS PAC ID: 1355615626
Enrollment ID: I20241217000466
Provider NameCourtney Jack
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1336740620
PECOS PAC ID: 8820403249
Enrollment ID: I20241231001234
Provider NameApril Gardner
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1184020836
PECOS PAC ID: 2163744921
Enrollment ID: I20250407001673
Provider NameAlexis Driscoll
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1124726849
PECOS PAC ID: 0345613691
Enrollment ID: I20250409001810
Provider NameAbbygail Maranger
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1902606882
PECOS PAC ID: 1951826759
Enrollment ID: I20250415000193
Provider NameShannon Roth
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1144208976
PECOS PAC ID: 0345268579
Enrollment ID: I20250430000652
Provider NameAshley Barajas
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1467918458
PECOS PAC ID: 4082954011
Enrollment ID: I20250611003488
Provider NameTiffany Mcintyre
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1194244053
PECOS PAC ID: 1456610328
Enrollment ID: I20250626002070
Provider NameBernadette M Warigi
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1720975014
PECOS PAC ID: 2466960323
Enrollment ID: I20250801002677
Provider NameMonica Stout
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1922493576
PECOS PAC ID: 9032495445
Enrollment ID: I20250815000087
Provider NameFelicia Aman
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1023376993
PECOS PAC ID: 5890069827
Enrollment ID: I20250820000234
Provider NameKirsten Leah Tennie
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1124866322
PECOS PAC ID: 8426551862
Enrollment ID: I20250911004217
Provider NameDillard Elmore
Provider TypePractitioner - Geriatric Medicine
Provider IdentifiersNPI Number: 1841225554
PECOS PAC ID: 1355355983
Enrollment ID: I20250923003255
Provider NameChristie Finney
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1245875996
PECOS PAC ID: 4587099312
Enrollment ID: I20250930003279
Provider NameJulija N/a Schoepp
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1942187844
PECOS PAC ID: 5799281606
Enrollment ID: I20250930003538
Provider NameAlisha Humagain
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1528871605
PECOS PAC ID: 6002313160
Enrollment ID: I20251007001753
Provider NameSara Koenemann
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1780046250
PECOS PAC ID: 8022317957
Enrollment ID: I20251028002257
Provider NameJessica Nichols
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1427261247
PECOS PAC ID: 7618061581
Enrollment ID: I20251209004022
Provider NameFoua Vang
Provider TypePractitioner - Physician Assistant
Provider IdentifiersNPI Number: 1588265284
PECOS PAC ID: 1355734476
Enrollment ID: I20251210003220
Provider NamePauline Delinois
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1275183931
PECOS PAC ID: 1658785142
Enrollment ID: I20251217000304
Provider NameEsther Copeland
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1346707338
PECOS PAC ID: 1850626045
Enrollment ID: I20251231002473
Provider NameRebecca Jones
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1699549386
PECOS PAC ID: 3476039827
Enrollment ID: I20260302003623
Provider NameAudrey Hubler
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1831754720
PECOS PAC ID: 4688917727
Enrollment ID: I20260303003671
Provider NameDaniel Chukwujekwu Obi
Provider TypePractitioner - Physician Assistant
Provider IdentifiersNPI Number: 1407589419
PECOS PAC ID: 6002387479
Enrollment ID: I20260605002934

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Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.