THEDACARE MEDICAL CENTER - NEW LONDON, INC. (NPI# 1144675745) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144675745 |
| Entity Type | Organization |
| Organization Name | THEDACARE MEDICAL CENTER - NEW LONDON, INC. |
| Other Organization Name | NEW LONDON FAMILY MEDICAL CENTER, INC |
| Practice Address |
370 S Main St Clintonville WI 54929-1632 |
| Mailing Address |
Po Box 2759 Appleton WI 54912-2759 |
| Practice Telephone | 9208305900 |
| Practice Fax Number | 9208305910 |
| Mailing Telephone | 9208305900 |
| Mailing Fax Number | 9208305910 |
| Enumeration Date | 2016-05-02 |
| Last Update Date | 2019-09-26 |
| Authorized Official Name | MARK STEVEN THOMPSON (CFO) |
| Authorized Official Telephone | 9208305885 |
| Is Organization Subpart | Y |
| Parent Organization Name | THEDACARE MEDICAL CENTER - NEW LONDON, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 282NC0060X |
General Acute Care Hospital Specialization: Critical Access |
1029 | WI | Hospitals |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | MEDICARE PTAN | 521326 | 01 |
| Other Name | Type Code |
|---|---|
| NEW LONDON FAMILY MEDICAL CENTER, INC | Former Legal Business Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386875466 | Thedacare Medical Center - New London, Inc. | Clinical Medical Laboratory | 1405 Mill St, New London, WI 54961-2155 | 2009-08-06 |
| 1073611083 | Thedacare Medical Center - New London, Inc. | Anesthesiology | 1405 Mill St, New London, WI 54961-2155 | 2006-09-21 |
| 1538127220 | Thedacare Medical Center - New London, Inc. | General Acute Care Hospital | 1405 Mill St, New London, WI 54961-2155 | 2006-05-02 |
| Street Address |
370 S MAIN ST |
| City | CLINTONVILLE |
| State | WI |
| Zip Code | 54929-1632 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174559132 | Cynthia Egan | Family Medicine | 370 S Main St, Clintonville, WI 54929-1632 | 2006-06-23 |
| 1801447925 | Thedacare Medical Center - Shawano, Inc. | Clinic/Center | 370 S Main St, Clintonville, WI 54929-1632 | 2019-09-20 |
| 1043721970 | Lauren E Dailey | Physician Assistant | 370 S Main St, Clintonville, WI 54929-1632 | 2017-10-18 |
| 1841603438 | Sara L Messner | Physician Assistant | 370 S Main St, Clintonville, WI 54929-1632 | 2014-06-11 |
| 1235563420 | Melanie Lynne Wilke | Physical Therapist | 370 S Main St, Clintonville, WI 54929-1632 | 2013-08-25 |
| 1548516941 | Lesley A Fuerst | Nurse Practitioner | 370 S Main St, Clintonville, WI 54929-1632 | 2012-08-03 |
| 1033379888 | Cindy Griswold | Nurse Practitioner | 370 S Main St, Clintonville, WI 54929-1632 | 2008-06-16 |
| 1285893370 | Chad A Landwehr | Physician Assistant | 370 S Main St, Clintonville, WI 54929-1632 | 2008-06-04 |
| 1538191630 | Rita Braund | Physician Assistant | 370 S Main St, Clintonville, WI 54929-1632 | 2006-07-07 |
| 1851328033 | Leslie Gray | Family Medicine | 370 S Main St, Clintonville, WI 54929-1632 | 2006-06-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003045402 | Griebenow Eyecare, S.c. | Optometrist | 45 10th St., Clintonville, WI 54929 | 2009-07-07 |
| 1093835266 | William Henry Krueger | Chiropractor | E9180 Golf Club Road, Clintonville, WI 54929 | 2007-03-30 |
| 1255445680 | Leah K. Smejkal | Physical Therapist | 114 E. Greentree Road, Clintonville, WI 54929 | 2006-08-19 |
| 1962422303 | Clintonville Area Ambulance Service | Ambulance | 16 N. Main, Clintonville, WI 54929 | 2006-07-20 |
| 1649225970 | Jill I. Timm | Physical Therapist | 114 E Greentree Road, Clintonville, WI 54929 | 2006-05-24 |
| 1104242999 | Cloverleaf Healthcare, Inc. | Skilled Nursing Facility | 1625 E Main St, Clintonville, WI 54929 | 2014-03-17 |
| 1124286406 | Ascension Medical Group-fox Valley Wisconsin, Inc | Clinic/Center | 61 Anne St, Clintonville, WI 54929 | 2008-05-23 |
| 1174734289 | Samuel John Buckett | Chiropractor | E9180 Golf Club Road, Clintonville, WI 54929 | 2007-05-24 |
| 1811057961 | Karen Agnete Johnson | Dentist | 112 S Main Street, Clintonville, WI 54929 | 2006-12-11 |
| 1164509154 | Erickson Home Medical Equipment LLC | Durable Medical Equipment & Medical Supplies | 8 S Main St, Clintonville, WI 54929 | 2006-11-01 |
| Find all providers in zip 54929 | ||||
| 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 |
|---|---|---|---|---|
| 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 | ||||
| City | CLINTONVILLE |
| Zip Code | 54929 |
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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.