ST. MARY'S HOSPITAL OF SUPERIOR (NPI# 1083657886) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083657886 |
| Entity Type | Organization |
| Organization Name | ST. MARY'S HOSPITAL OF SUPERIOR |
| Other Organization Name | ESSENTIA HEALTH ST. MARY'S HOSPITAL SUPERIOR |
| Practice Address |
3500 Tower Ave Superior WI 54880-5335 |
| Practice Telephone | 7153955400 |
| Mailing Telephone | 7153955400 |
| Enumeration Date | 2006-06-13 |
| Last Update Date | 2020-04-01 |
| Authorized Official Name | KIM PEARSON (ADMINISTRATOR) |
| Authorized Official Telephone | 7158177017 |
| Is Organization Subpart | Y |
| Parent Organization Name | ST. MARY'S HOSPITAL OF SUPERIOR |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QE0002X |
Clinic/Center Specialization: Emergency Care |
1032 | WI | Ambulatory Health Care Facilities |
| Y | 282NC0060X |
General Acute Care Hospital Specialization: Critical Access |
5516-800 | WI | Hospitals |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 1083657886 | 05 |
| Other Name | Type Code |
|---|---|
| Essentia Health St. Mary's Hospital Superior | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972710507 | St. Mary's Hospital of Superior | Medicare Defined Swing Bed Unit | 3500 Tower Ave, Superior, WI 54880-5335 | 2007-05-16 |
| 1700817079 | St. Mary's Hospital of Superior | Clinic/Center | 3500 Tower Ave, Superior, WI 54880-5335 | 2006-07-05 |
| 1588691588 | St. Mary's Hospital of Superior | Clinic/Center | 3500 Tower Ave, Superior, WI 54880-5335 | 2006-06-26 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | ST MARY'S HOSPITAL OF SUPERIOR | 3500 Tower Ave, Superior, WI 54880-5335 |
| Street Address |
3500 TOWER AVE |
| City | SUPERIOR |
| State | WI |
| Zip Code | 54880-5335 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801872080 | Vicki Brady | Nurse Practitioner | 3500 Tower Ave, Superior, WI 54880-5335 | 2005-12-19 |
| 1659911014 | Mary K Robinson | Social Worker | 3500 Tower Ave, Superior, WI 54880-4491 | 2020-01-13 |
| 1265093413 | Paige Lois Slemmons | Physical Therapist | 3500 Tower Ave, Superior, WI 54880-4491 | 2019-06-27 |
| 1164994513 | Elaina A Fischer | Nurse Practitioner | 3500 Tower Ave, Superior, WI 54880-4491 | 2018-12-26 |
| 1992229579 | Renee Christine Karth-pearson | Social Worker | 3500 Tower Ave, Superior, WI 54880-4491 | 2017-07-26 |
| 1821518267 | Ryan Morgan | Family Medicine | 3500 Tower Ave, Superior, WI 54880-4491 | 2017-06-27 |
| 1639699200 | Nicholas C. Ellefson | Family Medicine | 3500 Tower Ave, Superior, WI 54880-4491 | 2017-06-23 |
| 1760837819 | Eric James Estes | Physical Therapist | 3500 Tower Ave, Superior, WI 54880-4491 | 2016-04-26 |
| 1710352018 | Christina Drexler | Occupational Therapist | 3500 Tower Ave, Superior, WI 54880-5395 | 2015-12-11 |
| 1063881399 | The Duluth Clinic, Ltd. | Pharmacy | 3500 Tower Ave, Suite C, Superior, WI 54880-4685 | 2015-09-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104427194 | Alana Catherine Sullivan | Speech-Language Pathologist | 25 N 25th Street E, Superior, WI 54880 | 2020-11-05 |
| 1710524970 | Sean Wiberg Peterson | Specialist/Technologist | 1810 Catlin Ave, Room 1246, Superior, WI 54880 | 2019-12-06 |
| 1558858936 | Brent Adam Engstrom | Student in an Organized Health Care Education/Training Program | 1410 Nth 23rd Street, Superior, WI 54880 | 2018-04-20 |
| 1558769125 | David Kroll | Specialist | Balknap & Catlin Aves., Superior, WI 54880 | 2014-12-15 |
| 1154670321 | Superior Treatment Center, Inc | Community/Behavioral Health | 1507 Tower Ave Ste 307, Superior, WI 54880 | 2012-09-04 |
| 1548551658 | Dionne Jeannine Corcoran | Midwife | 916 Hammond Ave Ste 222, Superior, WI 54880 | 2011-04-22 |
| 1821235433 | Lauren Ashley Miller | Speech-Language Pathologist | 35 N. 28th Street, Superior, WI 54880 | 2009-01-20 |
| 1528261989 | Stacy Ann Kennelly | Physical Therapist | 1612 N 37th Street, Superior, WI 54880 | 2007-06-06 |
| 1760564942 | James Henry Dobis | Family Medicine | 3520 Tower Avenue, Twin Ports Va Outpatient Clinic, Superior, WI 54880 | 2006-10-19 |
| 1134214398 | Kevin M Mikel | Dentist | 3312 Tower Avenue, Superior, WI 54880 | 2006-10-04 |
| Find all providers in zip 54880 | ||||
| Taxonomy Code | 282NC0060X |
| Grouping | Hospitals |
| Classification | General Acute Care Hospital |
| Specialization | Critical Access |
| Definition to come. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306842604 | Brodstone Memorial Hospital | General Acute Care Hospital | 520 E 10th St, Superior, NE 68978-1225 | 2005-06-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710333893 | Thedacare Medical Center - Waupaca, Inc. | General Acute Care Hospital | N2610 Wi 22, Waupaca, WI 54981 | 2016-05-09 |
| 1255662573 | Donald Morris Levy | General Acute Care Hospital | 4348 W Tarrytown Ln, Mequon, WI 53092-4850 | 2010-01-26 |
| 1841483112 | Club Staffing | General Acute Care Hospital | 1082 Vinyard Dr, Oregon, WI 53575-3314 | 2007-08-21 |
| 1104953090 | New Anesthesia | General Acute Care Hospital | 1236 Stillmeadow Ln, Menasha, WI 54952-8920 | 2007-02-27 |
| 1184765240 | Tomah Memorial Hospital Inc | General Acute Care Hospital | 501 Gopher Dr, Tomah, WI 54660-4513 | 2007-02-10 |
| 1194737817 | Chippewa Valley Hospital & Oakview Care Center, Inc. | General Acute Care Hospital | 1220 3rd Ave W, Durand, WI 54736-1600 | 2006-08-12 |
| 1154350049 | Edgerton Hospital and Health Services | General Acute Care Hospital | 11101 N Sherman Rd, Edgerton, WI 53534-9002 | 2006-07-02 |
| 1881640183 | Westfields Hospital, Inc. | General Acute Care Hospital | 535 Hospital Road, New Richmond, WI 54017-1449 | 2006-05-26 |
| 1053362624 | Ripon Medical Center Inc | General Acute Care Hospital | 845 Parkside Street, Ripon, WI 54971-8505 | 2006-05-16 |
| 1255382933 | Cumberland Memorial Hospital | General Acute Care Hospital | 1110 7th Ave, Cumberland, WI 54829-9133 | 2006-05-15 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.