ST CLARE MEMORIAL HOSPITAL, INC (NPI# 1346371358) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346371358 |
| Entity Type | Organization |
| Organization Name | ST CLARE MEMORIAL HOSPITAL, INC |
| Other Organization Name | ST CLARE MEMORIAL HOSPITAL LENA HEALTH CENTER |
| Practice Address |
200 S. Rosera Street Lena WI 54139 |
| Mailing Address |
855 S Main St Oconto Falls WI 54154-1241 |
| Practice Telephone | 9208296400 |
| Practice Fax Number | 9208296403 |
| Mailing Telephone | 9208463444 |
| Mailing Fax Number | 9208460250 |
| Enumeration Date | 2007-03-08 |
| Last Update Date | 2014-09-02 |
| Authorized Official Name | DANIEL .DEGROOT (CEO) |
| Authorized Official Telephone | 9208463444 |
| Is Organization Subpart | Y |
| Parent Organization Name | ST CLARE MEMORIAL HOSPITAL, INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363A00000X | Physician Assistant | 1428-023 | WI | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 207Q00000X | Family Medicine | 38208-020 | WI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 41969700 | 05 | |
| WI | CUPINO BC | 294946191003 | 01 |
| WI | 11014110 | 05 | |
| WI | 32392300 | 05 | |
| CMH NPI | 1851477913 | 01 | |
| WI | RICHLEN BC | 3987482411009 | 01 |
| Other Name | Type Code |
|---|---|
| St Clare Memorial Hospital Lena Health Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750412292 | St Clare Memorial Hospital, Inc | Nurse Practitioner | 913 East Main Street, Suring, WI 54174 | 2007-03-08 |
| 1568552958 | St Clare Memorial Hospital, Inc | Family Medicine | 14353 Hwy 32/64, Mountain, WI 54149 | 2006-10-13 |
| 1326349135 | St Clare Memorial Hospital, Inc | Medicare Defined Swing Bed Unit | 855 S Main St, Oconto Falls, WI 54154-1241 | 2010-11-10 |
| 1700107844 | St Clare Memorial Hospital, Inc | Physical Therapist | 340 N Green Bay Ave, Gillett, WI 54124-9325 | 2010-06-11 |
| 1144541285 | St Clare Memorial Hospital, Inc | Occupational Therapist | 855 S Main St, Oconto Falls, WI 54154-1241 | 2010-06-11 |
| 1780851501 | St Clare Memorial Hospital, Inc | Clinical Medical Laboratory | 855 S Main St, Oconto Falls, WI 54154-1241 | 2008-05-12 |
| 1821216276 | St Clare Memorial Hospital, Inc | Obstetrics & Gynecology | 835 S Main St, Suite 2, Oconto Falls, WI 54154-1282 | 2007-04-23 |
| 1134250905 | St Clare Memorial Hospital, Inc | Nurse Practitioner | 340 N Green Bay Ave, Gillett, WI 54124-9325 | 2007-03-07 |
| 1467583278 | St Clare Memorial Hospital, Inc | Physician Assistant | 103 1st St, Oconto, WI 54153-1117 | 2007-03-07 |
| 1467583096 | St Clare Memorial Hospital, Inc | Family Medicine | 835 S Main St, Suite 1, Oconto Falls, WI 54154-1282 | 2007-03-07 |
| Street Address |
200 S. ROSERA STREET |
| City | LENA |
| State | WI |
| Zip Code | 54139 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710146998 | Jodi Ann Marquardt | Physical Therapy Assistant | 139 W Railroad St, Lena, WI 54139-0321 | 2008-06-03 |
| 1679136683 | St Vincent Hospital-hospital Sisters-third Order of St Francis | Clinic/Center | 200 S Rosera St, Lena, WI 54139-9169 | 2019-04-16 |
| 1306835350 | Isaias R Cupino Jr. | Family Medicine | 200 Rosera St, Lena, WI 54139-9169 | 2005-10-20 |
| 1366411993 | Janet Richlen | Physician Assistant | 200 Rosera St, Lena, WI 54139-9169 | 2006-03-16 |
| 1891052148 | Visions of New, LLC | In Home Supportive Care | 5739 Duame Rd, Lena, WI 54139-9172 | 2012-04-11 |
| 1902261571 | Stay At Homecare LLC | In Home Supportive Care | 150 S Rosera St, Lena, WI 54139-9192 | 2015-12-23 |
| 1790090827 | Julie Maree Graef | Registered Nurse | 201 4th St, Lena, WI 54139-9264 | 2010-08-12 |
| 1245465665 | Linda Gay Ziesmer | Registered Nurse | 5540 Burg Rd, Lena, WI 54139-9432 | 2009-05-29 |
| 1396924916 | Lena Public School District | Local Education Agency (LEA) | 304 E Main St, Lena, WI 54139-9488 | 2007-10-31 |
| 1720277999 | Jessica Jade Marie Haag | Specialist/Technologist | 5240 Mccarthy Rd, Lena, WI 54139-9534 | 2007-10-23 |
| Find all providers in zip 54139 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013983436 | Shokry Tawfik | Family Medicine | 160 W Main St, Lena, IL 61048-9247 | 2006-02-25 |
| 1306835350 | Isaias R Cupino Jr. | Family Medicine | 200 Rosera St, Lena, WI 54139-9169 | 2005-10-20 |
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| 1255974952 | Integrative Health Center of Central Wisconsin LLC | Family Medicine | 3205 E Washington Ave Ste A, Madison, WI 53704-4332 | 2019-10-25 |
| 1962969220 | Paladina Health, LLC | Family Medicine | Paladina Health Menomonee Falls, N84 W15787 Menomonee Avenue Suite 6, Menomonee Falls, WI 53051 | 2019-02-22 |
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| Find all providers with the same taxonomy | ||||
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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.