COLUMBIA ST MARY'S HOSPITAL OZAUKEE, INC. (NPI# 1184786329) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184786329 |
| Entity Type | Organization |
| Organization Name | COLUMBIA ST MARY'S HOSPITAL OZAUKEE, INC. |
| Other Organization Name | ASCENSION COLUMBIA ST MARY'S HOSPITAL OZAUKEE |
| Practice Address |
13111 N Port Washington Rd Mequon WI 53097-2416 |
| Mailing Address |
4425 N Port Washington Rd Glendale WI 53212-1082 |
| Practice Telephone | 2622437388 |
| Practice Fax Number | 2622437416 |
| Mailing Telephone | 4143262212 |
| Mailing Fax Number | 4143262208 |
| Enumeration Date | 2006-12-14 |
| Last Update Date | 2019-08-30 |
| Authorized Official Name | JONATHAN W SOHN (CFO) |
| Authorized Official Telephone | 4144653000 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
Ambulatory Health Care Facilities | ||
| Y | 273R00000X | Psychiatric Unit | 246 | WI | Hospital Units |
| Other Name | Type Code |
|---|---|
| Ascension Columbia St Mary's Hospital Ozaukee | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376582775 | Columbia St Mary's Hospital Ozaukee, Inc. | Clinic/Center | 4425 N Port Washington Rd, Glendale, WI 53212-1082 | 2006-06-05 |
| 1740747559 | Columbia St Mary's Hospital Ozaukee, Inc. | Psychiatric Unit | 13111 N Port Washington Rd, Mequon, WI 53097-2416 | 2019-02-28 |
| 1316000706 | Columbia St Mary's Hospital Ozaukee, Inc. | General Acute Care Hospital | 13111 N Port Washington Rd, Mequon, WI 53097-2416 | 2006-12-18 |
| Street Address |
13111 N PORT WASHINGTON RD |
| City | MEQUON |
| State | WI |
| Zip Code | 53097-2416 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053360933 | Infinity Healthcare Physicians, S.c. | Physician Assistant | 13111 N Port Washington Rd, Columbia St. Mary's - Ozaukee Campus, Mequon, WI 53097-2416 | 2006-05-09 |
| 1083251631 | Abbey Beck | Dietitian, Registered | 13111 N Port Washington Rd, Mequon, WI 53097-2416 | 2019-12-03 |
| 1184269326 | Whitney Gilbert | Social Worker | 13111 N Port Washington Rd, Mequon, WI 53097-2416 | 2019-11-12 |
| 1831733872 | Deidre Alexandra Marsh | Social Worker | 13111 N Port Washington Rd, Mequon, WI 53097-2416 | 2019-11-02 |
| 1043854474 | Elizabeth Shepler | Nurse Anesthetist, Certified Registered | 13111 N Port Washington Rd, Mequon, WI 53097-2416 | 2019-10-29 |
| 1053952028 | Marcus Sojka | Physical Therapist | 13111 N Port Washington Rd, Mequon, WI 53097-2416 | 2019-10-01 |
| 1740747559 | Columbia St Mary's Hospital Ozaukee, Inc. | Psychiatric Unit | 13111 N Port Washington Rd, Mequon, WI 53097-2416 | 2019-02-28 |
| 1508306671 | Philip W Diperna | Nurse Practitioner | 13111 N Port Washington Rd, Mequon, WI 53097-2416 | 2017-03-08 |
| 1932652732 | Karen Neusen | Occupational Therapist | 13111 N Port Washington Rd, Mequon, WI 53097-2416 | 2016-07-27 |
| 1255796181 | Magdalena Walentynowicz | Physician Assistant | 13111 N Port Washington Rd, Mequon, WI 53097-2416 | 2015-12-18 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851512982 | Wendy S Balister | Dietitian, Registered | 13111 North Port Washington Rd, Mequon, WV 53097 | 2007-05-02 |
| 1902985922 | Lisa Lang | Counselor | 14135 North Cedarburg Road, Mequon, WI 53097 | 2006-11-02 |
| 1003915570 | Joan T Gnadt | Internal Medicine | 13133 N Port Washington Rd., Suite 111, Mequon, WI 53097 | 2006-09-21 |
| 1255439097 | Susan J Riegg | Pathology | 13111 N Port Washington Road, Mequon, WI 53097 | 2006-09-20 |
| 1891808887 | Gregory Eric Custer | Dentist | 13615 N Cedarburg Road, Mequon, WI 53097 | 2006-08-16 |
| 1114958600 | Richard K Karr | Orthopaedic Surgery | 13133n Port Washington Road, #216, Mequon, WI 53097 | 2006-07-05 |
| 1548204712 | Lauretta Lyon Schears | Occupational Therapist | 13111 N. Portwashington Rd, Mequon, WI 53097 | 2006-06-16 |
| 1235173337 | Sarah Marie Neman | Physical Therapy Assistant | 13111 N Prot Washington Rd., Mequon, WI 53097 | 2006-06-16 |
| 1538103643 | Elizabeth Gral Sullivan | Speech-Language Pathologist | 13111 North Port Washington Road, Mequon, WI 53097 | 2006-06-16 |
| 1952808701 | Lisa Lang LLC | Counselor | 14135 North Cedarburg Road, Mequon, WI 53097 | 2018-04-09 |
| Find all providers in zip 53097 | ||||
| Taxonomy Code | 273R00000X |
| Grouping | Hospital Units |
| Classification | Psychiatric Unit |
| In general, a distinct unit of a hospital that provides acute or long-term care to emotionally disturbed patients, including patients admitted for diagnosis and those admitted for treatment of psychiatric problems on the basis of physicians' orders and approved nursing care plans. Long-term care may include intensive supervision to the chronically mentally ill, mentally disordered or other mentally incompetent persons; (2) For Medicare, a distinct part of a general acute care hospital admitting only patients whose admission to the unit is required for active treatment, whose treatment is of an intensity that can be provided only in an inpatient hospital setting, and whose condition is described by a psychiatric principal diagnosis contained in the Third Edition of the American Psychiatric Association Diagnostic and Statistical Manual or in Chapter 5 (Mental Disorders) of the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM). The unit must furnish, through the use of qualified personnel, psychological services, social work services, psychiatric nursing, occupational therapy, and recreational therapy. The unit must maintain medical records that permit determination of the degree and intensity of treatment provided to individuals who are furnished services in the unit; the unit must meet special staff requirements in that the unit must have adequate numbers of qualified professional and supportive staff to evaluate inpatients, formulate written, individualized, comprehensive treatment plans, provide active treatment measures and engage in discharge planning. |
| Notes: Source: (1) AHA Annual Survey p. A10 1996 AHA Guide; (2) Code of Federal Regulations #42, Section 412.27. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740747559 | Columbia St Mary's Hospital Ozaukee, Inc. | Psychiatric Unit | 13111 N Port Washington Rd, Mequon, WI 53097-2416 | 2019-02-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003182346 | James Arthur Hennes | Psychiatric Unit | 515 Veterans St., Tomah, WI 54660 | 2012-03-30 |
| 1417170283 | Aurora Health Care Metro, Inc. | Psychiatric Unit | 2900 W Oklahoma Ave., Milwaukee, WI 53215 | 2007-04-10 |
| 1811926132 | Columbia St. Mary's Hospital Milwaukee, Inc | Psychiatric Unit | 2323 N Lake Drive, Milwaukee, WI 53211-4508 | 2006-06-30 |
| 1437105624 | Community Memorial Hospital of Menomonee Falls Inc | Psychiatric Unit | W180 N 8085 Town Hall Rd, Menomonee Falls, WI 53052 | 2006-05-26 |
| 1093205163 | Ascension Ne Wisconsin, Inc | Psychiatric Unit | 500 S Oakwood Rd, Oshkosh, WI 54904 | 2018-05-15 |
| 1528560018 | Watertown Medical Center LLC | Psychiatric Unit | 125 Hospital Drive, Watertown, WI 53098 | 2018-03-01 |
| 1982901542 | Milwaukee County Mental Health Division | Psychiatric Unit | 9201 W Watertown Plank Rd, Milwaukee, WI 53226-3558 | 2011-02-17 |
| 1629221502 | Mohammad Mallick, Md, LLC | Psychiatric Unit | 1525 Liberty Ct, Brookfield, WI 53045-5327 | 2008-10-23 |
| 1184800468 | St. Josephs Community Hospital of West Bend Inc. | Psychiatric Unit | 3200 Pleasant Valley Rd, West Bend, WI 53095-9274 | 2008-01-16 |
| 1811172489 | Aurora Sinai Medical Center, Inc. | Psychiatric Unit | 945 N 12th St, Milwaukee, WI 53233-1305 | 2008-01-02 |
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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.