KICKAPOO VALLEY MEDICAL CLINIC - VMH
NPI 1376549824
Clinic/Center - Rural Health in Soldiers Grove, WI
NPI Status: Active since June 21, 2005
Contact Information
102 SUNSET AVE
SOLDIERS GROVE, WI
ZIP 54655
Phone: (608) 624-5203
Fax: (608) 624-5572
- Organization
- Clinic/Center
- Rural Health
- Accepts Insurance
- CLIA Number: 52D0396431
- CLIA Cert. Type: Rural Health Clinic
- CLIA Exp. Date: 07-19-2026
About KICKAPOO VALLEY MEDICAL CLINIC - VMH
This page provides the complete NPI Profile along with additional information for Kickapoo Valley Medical Clinic - Vmh, a primary care provider established in Soldiers Grove, Wisconsin operating as a Clinic/center, focusing in rural health . The healthcare provider is registered in the NPI registry with number 1376549824 assigned on June 2005. The practitioner's primary taxonomy code is 261QR1300X. The provider is registered as an organization and their NPI record was last updated 6 years ago. The provider's is doing business as Kickapoo Valley Medical Clinic - Vmh. The authorized official of this NPI record is David Hartberg (Ceo)
- NPI
- 1376549824
- Provider Legal Name
- VERNON MEMORIAL HEALTHCARE, INC.
- Other Organization Name
- KICKAPOO VALLEY MEDICAL CLINIC - VMH
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 102 SUNSET AVE SOLDIERS GROVE, WI 54655
- Location Phone
- (608) 624-5203
- Location Fax
- (608) 624-5572
- Mailing Address
- 507 S MAIN ST VIROQUA, WI 54665
- Mailing Phone
- (608) 624-5203
- Mailing Fax
- (608) 624-5572
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- Yes
- Enumeration Date
- 06-21-2005
- Last Update Date
- 01-07-2020
- Code Navigator
A primary care provider (PCP) like Kickapoo Valley Medical Clinic - Vmh sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc .
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Clinic/Center Rural Health
- Taxonomy Code
- 261QR1300X
- Type
- Ambulatory Health Care Facilities
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Anthem Bronze Preferred/Broad 5000 (3 Free PCP Visits + $0 Select Drugs + Incentives) - POS
- Anthem Bronze Preferred/Broad HSA (+ Incentives) - POS
- Anthem Bronze Preferred/Broad Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
- Anthem Bronze Priority/Lean 5000 (3 Free PCP Visits + $0 Select Drugs + Incentives) - HMO
- Anthem Bronze Priority/Lean HSA (+ Incentives) - HMO
- Anthem Bronze Priority/Lean Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Anthem Gold Preferred/Broad 1000 ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
- Anthem Gold Preferred/Broad Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
- Anthem Gold Priority/Lean 1000 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Anthem Gold Priority/Lean Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Anthem Heart Healthy Bronze Preferred/Broad 0 Med Ded ($0 Virtual PCP+$0 Select Drugs+Incentives) - POS
- Anthem Heart Healthy Bronze Priority/Lean 0 Med Ded ($0 Virtual PCP+$0 Select Drugs+Incentives) - HMO
- Anthem Silver Preferred/Broad 4000 (3 Free PCP Visits + $0 Select Drugs + Incentives) - POS
- Anthem Silver Preferred/Broad 5300 (3 Free PCP Visits + $0 Select Drugs + Incentives) - POS
- Anthem Silver Preferred/Broad Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
- Anthem Silver Priority/Lean 4000 (3 Free PCP Visits + $0 Select Drugs + Incentives) - HMO
- Anthem Silver Priority/Lean 5300 (3 Free PCP Visits + $0 Select Drugs + Incentives) - HMO
- Anthem Silver Priority/Lean Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Robin Oak $1,000 Gold - PPO
- Robin Oak $1,500 Standard Gold - PPO
- Engage by Medica Bronze HSA - EPO
- Engage by Medica Bronze Share - EPO
- Engage by Medica Expanded Bronze Standard - EPO
- Engage by Medica Gold $0 Copay PCP Visits - EPO
- Engage by Medica Gold Share - EPO
- Engage by Medica Gold Standard - EPO
- Engage by Medica Silver $0 Copay PCP Visits - EPO
- Engage by Medica Silver Share - EPO
- Engage by Medica Silver Standard - EPO
- QUARTZ ONE ACHIEVE BRONZE (DENTAL & VISION) $9100 DED FLAT RX COPAYS - IL - HMO
- QUARTZ ONE ACHIEVE BRONZE (DENTAL & VISION) STANDARD EASY PRICING - IL - HMO
- QUARTZ ONE ACHIEVE BRONZE (VISION) $7250 HSA - IL - HMO
- QUARTZ ONE ACHIEVE BRONZE (VISION) $9100 DED FLAT RX COPAYS - IL - HMO
- QUARTZ ONE ACHIEVE BRONZE (VISION) STANDARD EASY PRICING - IL - HMO
- QUARTZ ONE ACHIEVE CATASTROPHIC (VISION) - IL - HMO
- QUARTZ ONE ACHIEVE GOLD (DENTAL & VISION) $2500 DED - IL - HMO
- QUARTZ ONE ACHIEVE GOLD (VISION) $2500 DED - IL - HMO
- QUARTZ ONE ACHIEVE GOLD MAINTENANCE (DENTAL & VISION) $500 DED - IL - HMO
- QUARTZ ONE ACHIEVE GOLD MAINTENANCE (VISION) $500 DED - IL - HMO
- QUARTZ ONE ACHIEVE GOLD STANDARD (DENTAL & VISION) FLAT RX COPAYS EASY PRICING - IL - HMO
- QUARTZ ONE ACHIEVE GOLD STANDARD (VISION) FLAT RX COPAYS EASY PRICING - IL - HMO
- QUARTZ ONE ACHIEVE SILVER (DENTAL & VISION) $0 DED FLAT RX COPAYS - IL - HMO
- QUARTZ ONE ACHIEVE SILVER (DENTAL & VISION) $7000 DED - IL - HMO
- QUARTZ ONE ACHIEVE SILVER (DENTAL & VISION) STANDARD EASY PRICING - IL - HMO
- QUARTZ ONE ACHIEVE SILVER (VISION) $0 DED FLAT RX COPAYS - IL - HMO
- QUARTZ ONE ACHIEVE SILVER (VISION) $7000 DED - IL - HMO
- QUARTZ ONE ACHIEVE SILVER (VISION) STANDARD EASY PRICING - IL - HMO
- QUARTZ ONE ACHIEVE W/ADVOCATE HEALTH CARE BRONZE $0 MEDICAL DED - HMO
- QUARTZ ONE ACHIEVE W/ADVOCATE HEALTH CARE BRONZE $7250 HSA - HMO
- Premier $1,500 - 25% - HMO
- Premier $3,500 - 30% - HMO
- Premier $4,100 HDHP - HMO
- Premier $5,000 - 40% - HMO
- Premier $6,200 HDHP - HMO
- Premier $7,500 - HMO
- Premier $9,200 - HMO
- Premier Protection - HMO
- Premier HMO $1,500 - 30% - HMO
- Premier HMO $2,500 - 20% Copay - HMO
- Premier HMO $3,300 - 30% HDHP - HMO
- Premier HMO $3,500 - 30% - HMO
- Premier HMO $3,500 HDHP - HMO
- Premier HMO $4,000 - 20% HDHP - HMO
- Premier HMO $5,000 - 20% HDHP - HMO
- Premier HMO $5,500 - 30% Copay - HMO
- Premier HMO $7,050 HDHP - HMO
- Premier HMO $750 - 10% - HMO
- Premier HMO $9,100 - HMO
- Premier POS $1,500 - 30% - POS
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 52D0396431
- Facility Type
- Rural Health Clinic
- Certificate Effective Date
- July 20, 2024
- Certificate Expiration Date
- July 19, 2026
- Laboratory Director
- DR. WILLIAM N. CALKINS
- Certificate Type
- Certificate of Compliance
- Certificate Type Description
- This CLIA certificate is issued to Kickapoo Valley Medical Clinic - Vmh after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements. This type of certificate is issued to laboratories that perform nonwaived (moderate and/or high complexity) testing.
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 3 | 7 | 6 | 5 | 4 | 9 | 8 | 2 | 4 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 3 | 14 | 6 | 10 | 4 | 18 | 8 | 4 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 3 + 1 + 4 + 6 + 1 + 0 + 4 + 1 + 8 + 8 + 4 + 24 = 66 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 70 - 66 = 4 | 4 | ||||||||
The NPI number 1376549824 is valid because the calculated check digit 4 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 5 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1215974670 | PATRICIA A SWASKO A.P.N.P. Individual | Nurse Practitioner (Family) | 102 SUNSET AVE SOLDIERS GROVE, WI 54655 (608) 637-4230 |
| 1801838784 | TIMOTHY J DEVITT M.D. Individual | Family Medicine | 102 SUNSET AVE SOLDIERS GROVE, WI 54655 (608) 637-4230 |
| 1740224492 | TAMMY S PEDRETTI P.A. Individual | Physician Assistant | 102 SUNSET AVE SOLDIERS GROVE, WI 54655 (608) 637-4230 |
| 1194143487 | JOEL CHARLES M.D., M.P.H. Individual | Family Medicine | 102 SUNSET AVE SOLDIERS GROVE, WI 54655 (608) 624-5203 |
| 1982648697 | LISA J VARNES-EPSTEIN P.A. Individual | Physician Assistant | 102 SUNSET AVE SOLDIERS GROVE, WI 54655 (608) 624-5203 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1376549824, enumerated in the NPI registry as an "organization" on June 21, 2005
The provider is located at 102 Sunset Ave Soldiers Grove, Wi 54655 and the phone number is (608) 624-5203
This medical organization specializes in Clinic/Center with taxonomy code 261QR1300X with a focus in Rural Health
The provider might be accepting Accepts: Anthem Blue Cross and Blue Shield, HealthPartners,. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
The provider's CLIA number is 52D0396431 for a "rural health clinic" facility with a CLIA Certificate of Compliance. This CLIA certificate is issued after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements. This type of certificate is issued to laboratories that perform nonwaived (moderate and/or high complexity) testing..
This NPI record was last updated on June 21, 2005. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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