ST CLARE MEMORIAL HOSPITAL, INC (NPI# 1467583278) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467583278 |
| Entity Type | Organization |
| Organization Name | ST CLARE MEMORIAL HOSPITAL, INC |
| Other Organization Name | ST CLARE MEMORIAL HOSPITAL OCONTO HEALTH CENTER |
| Practice Address |
103 1st St Oconto WI 54153-1117 |
| Practice Telephone | 9208351144 |
| Practice Fax Number | 9208351145 |
| Mailing Telephone | 9208351144 |
| Mailing Fax Number | 9208351145 |
| Enumeration Date | 2007-03-07 |
| 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 | 1515-23 | WI | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363A00000X | Physician Assistant | 212-23 | WI | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 207Q00000X | Family Medicine | 25152-20 | WI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 11014110 | 05 | |
| NPI KNUTSON | 1760462352 | 01 | |
| CMH NPI | 1851477913 | 01 | |
| NPI FOX | 1477750644 | 01 | |
| NPI BIRK | 1215024716 | 01 |
| Other Name | Type Code |
|---|---|
| St Clare Memorial Hospital Oconto Health Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346371358 | St Clare Memorial Hospital, Inc | Physician Assistant | 200 S. Rosera Street, Lena, WI 54139 | 2007-03-08 |
| 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 |
| 1467583096 | St Clare Memorial Hospital, Inc | Family Medicine | 835 S Main St, Suite 1, Oconto Falls, WI 54154-1282 | 2007-03-07 |
| Street Address |
103 1ST ST |
| City | OCONTO |
| State | WI |
| Zip Code | 54153-1117 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760462352 | Thomas J. Knutson | Family Medicine | 103 1st St, Oconto, WI 54153-1117 | 2006-01-19 |
| 1437470572 | Community Memorial Hospital, Incorporated | Physical Therapist | 103 1st St, Oconto, WI 54153-1117 | 2010-06-11 |
| 1477750644 | Electa J Fox | Physician Assistant | 103 1st St, Oconto, WI 54153-1117 | 2007-06-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629240650 | Aurora Medical Group Inc | Durable Medical Equipment & Medical Supplies | 530 Smith Ave, Oconto, WI 54153 | 2008-03-31 |
| 1912997081 | Benzer Wi 1 LLC | Pharmacy | 1008 Main St, Oconto, WI 54153 | 2005-10-28 |
| 1245758127 | Hayley Joy Maxwell | Counselor | 501 Park Ave, Oconto, WI 54153 | 2017-08-31 |
| 1538542089 | Aliaksandr Trusau | Internal Medicine | 620 Smith Ave, Oconto, WI 54153 | 2015-07-01 |
| 1467879296 | Christopher Hanke | Counselor | 501 Park Ave, Oconto, WI 54153 | 2014-03-18 |
| 1669807020 | Joshua Ammon Weenig | Dentist | 1210 Pecor St, Oconto, WI 54153 | 2013-09-04 |
| 1609050798 | Bellin Psychiatric Center Inc | Clinic/Center | 820 Arbutus Ave, Oconto, WI 54153 | 2007-12-26 |
| 1932252533 | Oconto County Health & Human Services | Registered Nurse | 501 Park Ave, Oconto, WI 54153 | 2007-01-19 |
| 1841343449 | Oconto County Health & Human Services | Hospice Care, Community Based | 501 Park Ave, Oconto, WI 54153 | 2007-01-19 |
| 1457425951 | Lori Jo Eklund Walsh | Counselor | 820 Arbutus Ave, Oconto, WI 54153 | 2006-11-17 |
| Find all providers in zip 54153 | ||||
| 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 |
|---|---|---|---|---|
| 1255364543 | John S Honish | Family Medicine | 620 Smith Ave, Oconto, WI 54153-1080 | 2006-07-09 |
| 1043272727 | Bellin Memorial Hospital Inc | Family Medicine | 203 Smith Ave, Oconto, WI 54153-1060 | 2006-04-06 |
| 1760462352 | Thomas J. Knutson | Family Medicine | 103 1st St, Oconto, WI 54153-1117 | 2006-01-19 |
| 1295081677 | Bellin Health Oconto Clinic | Family Medicine | 820 Arbutus Ave, Oconto, WI 54153-2004 | 2012-08-03 |
| 1609018589 | Oconto Hospital & Medical Center, Inc. | Family Medicine | 820 Arbutus Ave, Oconto, WI 54153-2004 | 2009-03-24 |
| 1083721286 | Charles J Heyka | Family Medicine | 820 Arbutus Ave, Oconto, WI 54153-2004 | 2006-08-24 |
| 1851301253 | Elizabeth Joyce Russell | Family Medicine | 820 Arbutus Ave, Oconto, WI 54153-2004 | 2006-08-08 |
| 1306825872 | Iris Theodora C Perez-marquardt | Family Medicine | 820 Arbutus Ave, Oconto, WI 54153-2004 | 2006-01-12 |
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| 1962015552 | Callie Lund | Family Medicine | 418 Lotus St, Mosinee, WI 54455-1728 | 2020-08-25 |
| 1275159998 | Beam Healthcare, Sc | Family Medicine | 25 W Main St Fl 5, Madison, WI 53703-3399 | 2020-06-18 |
| 1487283503 | Enitza Damaris George | Family Medicine | 1906 Brackett Ave, Eau Claire, WI 54701-5042 | 2020-04-02 |
| 1093341380 | Tia Marie Vaccaro | Family Medicine | 1275 Judd Rd, Oregon, WI 53575-2573 | 2020-03-18 |
| 1134753411 | Proactive Md Sc,p.a. | Family Medicine | Brakebush Health Center, N4993 6th Dr., Westfield, WI 53964 | 2020-02-26 |
| 1790323608 | Solidaritus Health Wisconsin Sc | Family Medicine | 1476 Blazing Star Blvd Ste 4, Altoona, WI 54720-4002 | 2019-12-11 |
| 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 |
| 1942767298 | Paladina Health, LLC | Family Medicine | Paladina Health Sussex Beer Capitol Clinic, W222 N5700 Miller Way, Sussex, WI 53069 | 2019-02-22 |
| 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.