THEDACARE MEDICAL CENTER - BERLIN, INC. (NPI# 1275943367) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275943367 |
| Entity Type | Organization |
| Organization Name | THEDACARE MEDICAL CENTER - BERLIN, INC. |
| Other Organization Name | CHN ANESTHESIA |
| Practice Address |
225 Memorial Dr Berlin WI 54923-1243 |
| Mailing Address |
Po Box 2759 Appleton WI 54912-2759 |
| Practice Telephone | 9203615538 |
| Practice Fax Number | 9203615499 |
| Mailing Telephone | 9208305900 |
| Mailing Fax Number | 9208305910 |
| Enumeration Date | 2014-04-29 |
| Last Update Date | 2019-09-06 |
| Authorized Official Name | MR. MARK S THOMPSON (CHIEF FINANCIAL OFFICER) |
| Authorized Official Telephone | 9208305885 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207L00000X | Anesthesiology | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 11011000 | 05 |
| Other Name | Type Code |
|---|---|
| CHN Anesthesia | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023154929 | Thedacare Medical Center - Berlin, Inc. | Skilled Nursing Facility | 482 Oak St, Berlin, WI 54923-1204 | 2007-01-29 |
| 1447243399 | Thedacare Medical Center - Berlin, Inc. | Home Health | 402 Preston Lane, Redgranite, WI 54970 | 2005-08-25 |
| 1326493602 | Thedacare Medical Center - Berlin, Inc. | General Acute Care Hospital | 1080 W Fond Du Lac St, Ripon, WI 54971-9286 | 2016-04-25 |
| 1992159289 | Thedacare Medical Center - Berlin, Inc. | General Acute Care Hospital | N2930 State Road 22, Wautoma, WI 54982-5267 | 2016-04-22 |
| 1760413777 | Thedacare Medical Center - Berlin, Inc. | General Acute Care Hospital | 225 Memorial Drive, Berlin, WI 54923-1243 | 2006-07-06 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | THEDACARE MEDICAL CENTER - BERLIN, INC. | 225 Memorial Dr, Berlin, WI 54923-1243 |
| Street Address |
225 MEMORIAL DR |
| City | BERLIN |
| State | WI |
| Zip Code | 54923-1243 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962403832 | M Jean Bruce | Family Medicine | 225 Memorial Dr, Suite 1200, Berlin, WI 54923-1243 | 2005-08-02 |
| 1841814472 | Benjamin John Kozloski | Nurse Anesthetist, Certified Registered | 225 Memorial Dr, Berlin, WI 54923-1243 | 2020-05-29 |
| 1003439720 | Courtney Disterhaft | Physical Therapist | 225 Memorial Dr, Berlin, WI 54923-1243 | 2020-05-28 |
| 1457911984 | Nolan S Baker | Speech-Language Pathologist | 225 Memorial Dr, Berlin, WI 54923-1243 | 2019-06-17 |
| 1477043313 | Lina D Ramos | Registered Nurse | 225 Memorial Dr, Berlin, WI 54923 | 2018-05-16 |
| 1891291167 | Northeast Wisconsin Foot and Ankle Assoc., S.c. | Podiatrist | 225 Memorial Dr, Berlin, WI 54923-1243 | 2018-04-04 |
| 1437606373 | Sherry Lynn Reinsbach | Occupational Therapy Assistant | 225 Memorial Dr, Berlin, WI 54923-1243 | 2016-09-08 |
| 1528513272 | Jessica M Braun | Physical Therapy Assistant | 225 Memorial Dr, Berlin, WI 54923-1243 | 2016-08-23 |
| 1326592270 | Brandon Eric Mcmullen | Physical Therapist | 225 Memorial Dr, Berlin, WI 54923-1243 | 2016-08-09 |
| 1508310467 | Marissa Marie Schleis | Physical Therapist | 225 Memorial Dr, Berlin, WI 54923-1243 | 2016-08-09 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053910067 | Mary Ellen F Pumper | Pharmacist | 861 County Rd F, Berlin, WI 54923 | 2020-10-21 |
| 1962020792 | Brown Wilcox Trustees, Inc. | Home Health | 347 East Huron Street, Berlin, WI 54923 | 2020-07-08 |
| 1083050942 | Veterinary Clinic Berlin/ripon | Veterinarian | W1915 Cty Road F, Berlin, WI 54923 | 2013-05-20 |
| 1114078243 | David Earl Johanknecht | Optometrist | 269 Memorial Dr, Suite 103, Berlin, WI 54923 | 2007-01-16 |
| 1043314677 | William Harold Hastreiter | Dentist | 102 W Huron St, Berlin, WI 54923 | 2006-09-12 |
| 1699725333 | Kurt Alan Zemke | Dentist | 280 South Church St, Berlin, WI 54923 | 2006-05-11 |
| 1942280821 | Dina N Nelson | Nurse Anesthetist, Certified Registered | 225 Memorial Drive, Anesthesia Dept, Berlin, WI 54923 | 2006-01-18 |
| 1679574453 | Craig Batley | Family Medicine | W832 Hwy 91, Suite 3, Berlin, WI 54923 | 2005-08-03 |
| 1760887392 | Waushara Dental Associate Sc | Dentist | 322 Broadway, Berlin, WI 54923 | 2014-10-24 |
| 1750673513 | Kristy E Wagner | Occupational Therapy Assistant | 225 Memorial Drive, Berlin, WI 54923 | 2011-05-11 |
| Find all providers in zip 54923 | ||||
| Taxonomy Code | 207L00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Anesthesiology |
| An anesthesiologist is trained to provide pain relief and maintenance, or restoration, of a stable condition during and immediately following an operation or an obstetric or diagnostic procedure. The anesthesiologist assesses the risk of the patient undergoing surgery and optimizes the patient's condition prior to, during and after surgery. In addition to these management responsibilities, the anesthesiologist provides medical management and consultation in pain management and critical care medicine. Anesthesiologists diagnose and treat acute, long-standing and cancer pain problems; diagnose and treat patients with critical illnesses or severe injuries; direct resuscitation in the care of patients with cardiac or respiratory emergencies, including the need for artificial ventilation; and supervise post-anesthesia recovery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Anesthesiology, 2007. http://www.theaba.org/; American Osteopathic Board of Anesthesiology, 2007, http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Anesthesiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Anesthesiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992961312 | John Hamilton | Anesthesiology | 14 Meadow St, Berlin, MD 21811-1300 | 2008-08-05 |
| 1033172853 | Michael William Abajian | Anesthesiology | 130 Fisher Road, Central Vermont Medical Center, Berlin, VT 05641-0547 | 2006-04-11 |
| 1245506153 | James E. Wolf | Anesthesiology | 130 Fisher Rd., Uvm Medical Network/cvmc Anesthesiology, Berlin, VT 05602 | 2012-03-25 |
| 1700179413 | Stephen Alexander Chin | Anesthesiology | 9733 Healthway Dr, Agh Department of Anesthesiology, Berlin, MD 21811-1155 | 2011-05-27 |
| 1043417314 | Scott Edward Knowlton | Anesthesiology | 9733 Healthway Drive, Berlin, MD 21811-1288 | 2007-06-29 |
| 1184646366 | Andre Breidenthal Gilbert | Anesthesiology | 130 Fisher Rd, Central Vermont Medical Center, Berlin, VT 05602-9516 | 2006-07-24 |
| 1205858495 | Maria C. Aveni | Anesthesiology | 130 Fisher Rd, Central Vermont Medical Center, Berlin, VT 05602-9516 | 2006-07-24 |
| 1386663474 | Central Vermont Anesthesia Associates, Inc. | Anesthesiology | 130 Fisher Rd, Central Vermont Medical Center, Berlin, VT 05602-9516 | 2006-07-19 |
| 1699794875 | Christopher J Rohan | Anesthesiology | 130 Fisher Rd, Central Vermont Medical Center, Berlin, VT 05602-9516 | 2006-07-19 |
| 1720007800 | Elke Pinn | Anesthesiology | 130 Fisher Rd, Central Vermont Medical Center, Berlin, VT 05602-9516 | 2006-07-19 |
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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.