Solidaritus Health Wisconsin SC
NPI 1104711605ActiveOrganization· Family Medicine· Oconomowoc, WI
Family Medicine in Oconomowoc, Wisconsin, registered in NPPES in June 2025, part of Solidaritus Health Wisconsin SC. The authorized official on file is Georgia Jaquette Smith, Practice Manager.
Overview
| NPI | 1104711605 |
|---|---|
| Status | Active |
| Entity type | Organization (subpart) |
| Parent organization | Solidaritus Health Wisconsin SC |
| NPI issued | Jun 12, 2025 |
| Last updated in NPPES | Jun 12, 2025 |
| Certified by provider | Jun 12, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Family Medicine Primary | 207Q00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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