THEDACARE MEDICAL CENTER - SHAWANO, INC.


Address: 100 County Road B, Shawano, WI 54166-7072
Phone: 7155262111

THEDACARE MEDICAL CENTER - SHAWANO, INC. (NPI# 1265618979) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1265618979
Entity Type Organization
Organization Name THEDACARE MEDICAL CENTER - SHAWANO, INC.
Other Organization Name SHAWANO MEDICAL CENTER, INC.
Practice Address 100 County Road B
Shawano
WI 54166-7072
Mailing Address Po Box 2759
Appleton
WI 54912-2759
Practice Telephone 7155262111
Practice Fax Number 7155267308
Mailing Telephone 9208305900
Mailing Fax Number 9208305910
Enumeration Date 2008-01-11
Last Update Date 2019-09-06
Authorized Official Name MR. MARK S THOMPSON (CFO)
Authorized Official Telephone 9208305885
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 275N00000X Medicare Defined Swing Bed Unit 1051 WI Hospital Units

Other Provider/Organization Names

Other Name Type Code
SHAWANO MEDICAL CENTER, INC. Former Legal Business Name - Organization

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1548260839 Thedacare Medical Center - Shawano, Inc. General Acute Care Hospital 100 County Road B, Shawano, WI 54166-7072 2005-07-28
1801447925 Thedacare Medical Center - Shawano, Inc. Clinic/Center 370 S Main St, Clintonville, WI 54929-1632 2019-09-20
1649821760 Thedacare Medical Center - Shawano, Inc. Clinic/Center 100 County Road B, Shawano, WI 54166-7072 2019-09-20
1720493125 Thedacare Medical Center - Shawano, Inc. Clinical Medical Laboratory 100 County Road B, Shawano, WI 54166-7072 2014-06-24
1710206636 Thedacare Medical Center - Shawano, Inc. Non-Pharmacy Dispensing Site 6501 City West Pkwy, Eden Prairie, MN 55344-3248 2010-05-18

Office Location

Street Address 100 COUNTY ROAD B
City SHAWANO
State WI
Zip Code 54166-7072

Providers in the same location

NPI Name Taxonomy Address Enumeration
1548260839 Thedacare Medical Center - Shawano, Inc. General Acute Care Hospital 100 County Road B, Shawano, WI 54166-7072 2005-07-28
1053929653 Jenna J Mulder Student in an Organized Health Care Education/Training Program 100 County Road B, Shawano, WI 54166-7072 2020-07-20
1730704420 Katherine Dewane Registered Nurse 100 County Road B, Shawano, WI 54166-7072 2020-06-09
1063046761 Amanda Nicole Walbrun Physician Assistant 100 County Road B, Shawano, WI 54166-7072 2020-03-03
1952932972 Kerry L Baird Registered Nurse 100 County Road B, Shawano, WI 54166-7072 2020-01-29
1417599804 Calla J Scheel Registered Nurse 100 County Road B, Shawano, WI 54166-7072 2019-10-17
1649821760 Thedacare Medical Center - Shawano, Inc. Clinic/Center 100 County Road B, Shawano, WI 54166-7072 2019-09-20
1477100477 Cynthia M Bohringer Registered Nurse 100 County Road B, Shawano, WI 54166-7072 2019-08-23
1619523115 Heather Kristine Elertson Registered Nurse 100 County Road B, Shawano, WI 54166-7072 2019-08-12
1164084760 Matthew James Osborne Physical Therapist 100 County Road B, Shawano, WI 54166-7072 2019-07-03
Find all providers in the same location

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1134641848 Nicole Jeannine Klotzbuecher Optometrist 150 County Road B, Shawano, WI 54166 2017-07-13
1437605714 Jennifer Marie Franke Counselor 504 Lakeland St, Shawano, WI 54166 2016-08-28
1699017913 Benjamin D Schlais Family Medicine 100 County Hwy B, Shawano, WI 54166 2013-03-25
1154574366 Luke T Johnson Speech-Language Pathologist N3684 River Road, Shawano, WI 54166 2008-10-31
1902054315 Robert Joseph Bohr Jr. Physical Therapy Assistant N6590 Fox Lane, Shawano, WI 54166 2008-08-28
1790945863 Patricia Rae Ainsworth Physical Therapist 1436 South Lincoln Street, Shawano, WI 54166 2008-06-12
1649491820 Shawano-gresham School District Local Education Agency (LEA) 1050 South Union Street, Shawano, WI 54166 2007-05-02
1114043387 Thomas G Peterson Optometrist 150a County Road B, Shawano, WI 54166 2007-03-21
1740343086 John Milton Dovorany Dentist 1488 E Green Bay St, Shawano, WI 54166 2006-12-18
1265526305 Charles E Lamarche Counselor 420 E Green Bay St, Ste 201, Shawano, WI 54166 2006-10-03
Find all providers in zip 54166

Taxonomy Information

Taxonomy Code 275N00000X
Grouping Hospital Units
Classification Medicare Defined Swing Bed Unit

Taxonomy Definition

A unit of a hospital that has a Medicare provider agreement and has been granted approval from HCFA to provide post-hospital extended care services and be reimbursed as a swing-bed unit.
Notes: Source: Code of Federal Regulations #42, Section 482.66.

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1407096266 Ascension Good Samaritan Hospital, Inc. Medicare Defined Swing Bed Unit 601 S. Center Ave, Merrill, WI 54452-3404 2009-03-05
1306051990 St. Joseph's Health Services, Inc. Medicare Defined Swing Bed Unit 400 Water Ave., Hillsboro, WI 54634 2007-05-14
1194348896 Thedacare Regional Medical Center-neenah, Inc. Medicare Defined Swing Bed Unit 130 2nd St, Neenah, WI 54956-2883 2020-05-28
1326661026 Thedacare Regional Medical Center - Appleton, Inc. Medicare Defined Swing Bed Unit 1818 N Meade St, Appleton, WI 54911-3454 2020-05-28
1346716263 Mchs Hospitals, Inc. Medicare Defined Swing Bed Unit 900 College Ave W, Ladysmith, WI 54848-2116 2018-10-18
1689151599 Oconto Hospital & Medical Center Inc Medicare Defined Swing Bed Unit 820 Arbutus Ave, Oconto, WI 54153-2004 2018-07-24
1659786457 Mercy Health System Corporation Medicare Defined Swing Bed Unit N2950 State Road 67, Lake Geneva, WI 53147-2655 2014-07-01
1326349135 St Clare Memorial Hospital, Inc Medicare Defined Swing Bed Unit 855 S Main St, Oconto Falls, WI 54154-1241 2010-11-10
1720252893 Aurora Medical Center of Manitowoc County, Inc. Medicare Defined Swing Bed Unit 5000 Memorial Dr, Two Rivers, WI 54241-3900 2008-04-18
1124202320 Ascension Sacred Heart - St. Mary's Hospitals, Inc. Medicare Defined Swing Bed Unit 2251 N Shore Dr Ste 100, Rhinelander, WI 54501-8360 2007-12-24
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Competitor

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City SHAWANO
Zip Code 54166

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Dataset Information

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.

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