# BAYCARE CLINIC, LLP

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1285908970
- **Authorized official:** TAYLOR KONKLE (PAYOR ENROLLMENT)
- **Authorized official phone:** (920) 301-1327

## Contact information

- **Practice address:** 2401 HOLMGREN WAY, GREEN BAY, WI 54304-5224
- **Practice address phone:** (920) 497-0003
- **Practice address fax:** (920) 497-0024
- **Mailing address:** PO BOX 28900, GREEN BAY, WI 54324-0900
- **Mailing address phone:** (920) 490-9046
- **Mailing address fax:** (920) 405-8005

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | NULL | Yes |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | — | Yes |
| 2081P2900X | Pain Medicine (Physical Medicine & Rehabilitation) Physician | — | NULL | — |
| 2081P2900X | Pain Medicine (Physical Medicine & Rehabilitation) Physician | — | — | — |
| 208VP0014X | Interventional Pain Medicine Physician | — | NULL | — |
| 208VP0014X | Interventional Pain Medicine Physician | — | — | — |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | WI | — |

## Other

- **Enumeration date:** 02/28/2012
- **Last updated:** 08/27/2026