Provider Demographics
NPI:1417834565
Name:COMMONHEART, INC.
Entity type:Organization
Organization Name:COMMONHEART, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JUSTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:MUNZEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:920-328-1029
Mailing Address - Street 1:1045 HILL ST
Mailing Address - Street 2:
Mailing Address - City:WATERTOWN
Mailing Address - State:WI
Mailing Address - Zip Code:53098-3015
Mailing Address - Country:US
Mailing Address - Phone:844-206-4930
Mailing Address - Fax:920-261-7327
Practice Address - Street 1:N16W23217 STONE RIDGE DR STE 350
Practice Address - Street 2:
Practice Address - City:WAUKESHA
Practice Address - State:WI
Practice Address - Zip Code:53188-1171
Practice Address - Country:US
Practice Address - Phone:844-206-4930
Practice Address - Fax:920-261-7327
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-20
Last Update Date:2025-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QH0002XAllopathic & Osteopathic PhysiciansFamily MedicineHospice and Palliative MedicineGroup - Single Specialty