THEDACARE MEDICAL CENTER - BERLIN, INC. (NPI# 1326493602) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1326493602 |
| Entity Type | Organization |
| Organization Name | THEDACARE MEDICAL CENTER - BERLIN, INC. |
| Other Organization Name | COMMUNITY HEALTH NETWORK, INC. AND BERLIN MEMORIAL HOSPITAL |
| Practice Address |
1080 W Fond Du Lac St Ripon WI 54971-9286 |
| Mailing Address |
Po Box 2759 Appleton WI 54912-2759 |
| Practice Telephone | 9203611313 |
| Mailing Telephone | 9208305900 |
| Mailing Fax Number | 9208305910 |
| Enumeration Date | 2016-04-25 |
| Last Update Date | 2019-09-06 |
| Authorized Official Name | MR. MARK S THOMPSON (CHIEF FINANCIAL OFFICER) |
| Authorized Official Telephone | 9208305885 |
| Is Organization Subpart | Y |
| Parent Organization Name | THEDACARE MEDICAL CENTER - BERLIN, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 282NC0060X |
General Acute Care Hospital Specialization: Critical Access |
1060 | WI | Hospitals |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | MEDICARE PTAN | 527206 | 01 |
| Other Name | Type Code |
|---|---|
| COMMUNITY HEALTH NETWORK, INC. AND BERLIN MEMORIAL HOSPITAL | Former Legal Business 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 |
| 1992159289 | Thedacare Medical Center - Berlin, Inc. | General Acute Care Hospital | N2930 State Road 22, Wautoma, WI 54982-5267 | 2016-04-22 |
| 1275943367 | Thedacare Medical Center - Berlin, Inc. | Anesthesiology | 225 Memorial Dr, Berlin, WI 54923-1243 | 2014-04-29 |
| 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 |
1080 W FOND DU LAC ST |
| City | RIPON |
| State | WI |
| Zip Code | 54971-9286 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891796678 | Linda Ahrens | Registered Nurse | 1080 W Fond Du Lac St, Ripon, WI 54971-9286 | 2005-08-03 |
| 1730542408 | Thedacare, Incorporated | Family Medicine | 1080 W Fond Du Lac St, Ripon, WI 54971-9286 | 2016-03-31 |
| 1093132276 | Rachel M Kurinsky | Family Medicine | 1080 W Fond Du Lac St, Ripon, WI 54971-9286 | 2014-03-25 |
| 1700222064 | Steven Taylor Rasmussen | Family Medicine | 1080 W Fond Du Lac St, Ripon, WI 54971-9286 | 2013-05-14 |
| 1013274356 | Sandralee S Quade | Nurse Practitioner | 1080 W Fond Du Lac St, Ripon, WI 54971-9286 | 2012-04-11 |
| 1003115064 | Community Health Network Inc | Family Medicine | 1080 W Fond Du Lac St, Ripon, WI 54971-9286 | 2011-03-16 |
| 1649446105 | Lori Ann Badtke | Physical Therapist | 1080 W Fond Du Lac St, Ripon, WI 54971-9286 | 2008-05-05 |
| 1366649030 | Northeast Wisconsin Vision Center, Ltd | Technician/Technologist | 1080 W Fond Du Lac St, Ripon, WI 54971-9286 | 2007-06-27 |
| 1497747885 | Cheryl J Iverson | Family Medicine | 1080 W Fond Du Lac St, Ripon, WI 54971-9286 | 2005-08-22 |
| 1699767301 | Paul D Nelsen | Family Medicine | 1080 W Fond Du Lac St, Ripon, WI 54971-9286 | 2005-08-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659850113 | Kaitlyn J Smith | Physical Therapist | 402 Eureka St, Ripon, WI 54971 | 2018-08-07 |
| 1336667526 | Cooperleaf Management Group | Assisted Living Facility | 1002 Eureka Street, Ripon, WI 54971 | 2017-09-07 |
| 1750618062 | Midel Incorporated | Assisted Living Facility | 530 North Union St., Ripon, WI 54971 | 2009-11-06 |
| 1073847471 | Consultants Laboratory of Wi, LLC | Clinical Medical Laboratory | 790 Eastgate Dr, Ripon, WI 54971 | 2009-10-01 |
| 1598963415 | Joan Frances Nault I | Dentist | 702 E. Fond Du Lac St., Ripon, WI 54971 | 2007-07-03 |
| 1245366145 | Kathleen A Schumacher | Music Therapist | 1881 Rabbit Trail Road, Ripon, WI 54971 | 2007-02-26 |
| 1275680555 | Chris Schattschneider | Specialist/Technologist | 933 Newbury St., Ripon, WI 54971 | 2007-01-05 |
| 1225114010 | Kurt W Piernot | Dentist | 106 Watson St, Ripon, WI 54971 | 2006-10-27 |
| 1154427250 | Sarah Ann Heyn | Social Worker | 723 Chester Court, Ripon, WI 54971 | 2006-09-15 |
| 1023057320 | Joseph Longo | Family Medicine | 1080 W Fond Du Lac St., Chn Medical Center - Ripon, Ripon, WI 54971 | 2006-06-05 |
| Find all providers in zip 54971 | ||||
| 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 |
|---|---|---|---|---|
| 1053362624 | Ripon Medical Center Inc | General Acute Care Hospital | 845 Parkside Street, Ripon, WI 54971-8505 | 2006-05-16 |
| 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 |
| 1255382933 | Cumberland Memorial Hospital | General Acute Care Hospital | 1110 7th Ave, Cumberland, WI 54829-9133 | 2006-05-15 |
| 1114987054 | Lafayette County | General Acute Care Hospital | 800 Clay St, Darlington, WI 53530-1228 | 2006-03-24 |
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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.