AGNESIAN HEALTHCARE, INC (NPI# 1538147749) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538147749 |
| Entity Type | Organization |
| Organization Name | AGNESIAN HEALTHCARE, INC |
| Other Organization Name | ST AGNES HOSPITAL PHYSICAL REHAB |
| Practice Address |
430 E Division St Fond Du Lac WI 54935-4560 |
| Practice Telephone | 9209292300 |
| Practice Fax Number | 9209268885 |
| Mailing Telephone | 9209292300 |
| Mailing Fax Number | 9209268885 |
| Enumeration Date | 2006-01-06 |
| Last Update Date | 2017-05-02 |
| Authorized Official Name | BONNIE R SCHMITZ (CFO) |
| Authorized Official Telephone | 9209264480 |
| Is Organization Subpart | Y |
| Parent Organization Name | AGNESIAN HEALTHCARE, INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 273Y00000X | Rehabilitation Unit | Hospital Units |
| Other Name | Type Code |
|---|---|
| ST AGNES HOSPITAL PHYSICAL REHAB | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942274717 | Agnesian Healthcare, Inc | Hospice Care, Community Based | 239 Trowbridge Dr, Fond Du Lac, WI 54937-9180 | 2006-02-16 |
| 1861467144 | Agnesian Healthcare, Inc | Home Health | 239 Trowbridge Dr, Fond Du Lac, WI 54937-9180 | 2006-02-21 |
| 1114992492 | Agnesian Healthcare, Inc | Home Infusion | 430 E Division St, Fond Du Lac, WI 54935-4560 | 2006-02-21 |
| 1346228541 | Agnesian Healthcare, Inc | General Acute Care Hospital | 430 E Division St, Fond Du Lac, WI 54935-4560 | 2006-01-06 |
| 1578541785 | Agnesian Healthcare, Inc | Skilled Nursing Facility | 430 E Division St, Fond Du Lac, WI 54935-4560 | 2006-01-06 |
| 1598743726 | Agnesian Healthcare, Inc | Psychiatric Unit | 430 E Division St, Fond Du Lac, WI 54935-4560 | 2006-01-06 |
| Street Address |
430 E DIVISION ST |
| City | FOND DU LAC |
| State | WI |
| Zip Code | 54935-4560 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437157831 | Gilberto Cantu | Nurse Anesthetist, Certified Registered | 430 E Division St, Fond Du Lac, WI 54935-4560 | 2005-07-09 |
| 1992306310 | Leah Timm | Nurse Practitioner | 430 E Division St, Fond Du Lac, WI 54935-4560 | 2020-11-03 |
| 1982212312 | Tiffany M Parker | Counselor | 430 E Division St, Fond Du Lac, WI 54935-4560 | 2020-07-22 |
| 1619594355 | Brynn Sytsma | Student in an Organized Health Care Education/Training Program | 430 E Division St, Fond Du Lac, WI 54935-4560 | 2020-06-29 |
| 1891312633 | Joshua Mckinney | Counselor | 430 E Division St, Fond Du Lac, WI 54935-4560 | 2020-06-27 |
| 1275153264 | Jacalyn Lucille Wendt Coleman | Dietitian, Registered | 430 E Division St, Fond Du Lac, WI 54935-4560 | 2020-04-20 |
| 1568090884 | Jaclyn R Monteverde | Physician Assistant | 430 E Division St, Fond Du Lac, WI 54935-4560 | 2020-03-31 |
| 1235766718 | Emily Jean Thiel | Dietitian, Registered | 430 E Division St, Fond Du Lac, WI 54935-4560 | 2020-03-25 |
| 1326674136 | Alexandria Lynn Hefter | Nurse Practitioner | 430 E Division St, Fond Du Lac, WI 54935-4560 | 2020-03-13 |
| 1952933046 | Gina Paveglio | Registered Nurse | 430 E Division St, Surgery Dept, Fond Du Lac, WI 54935 | 2020-02-07 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609482249 | Keziah Sherri Love | Counselor | W390 Wi-23, Fond Du Lac, WI 54935 | 2020-09-18 |
| 1891341988 | Cynthia Louise Singleton | Nurse Practitioner | 16 E 13th St., Fond Du Lac, WI 54935 | 2019-08-14 |
| 1083183297 | Elena Alexandra Giese | Nurse Practitioner | 430 E. Division St, Fond Du Lac, WI 54935 | 2018-11-16 |
| 1669963740 | Elizabeth Anne Machi | Student in an Organized Health Care Education/Training Program | 885 Western Ave Ste 300, Fond Du Lac, WI 54935 | 2018-05-23 |
| 1184150021 | Jordan Moehn | Specialist/Technologist | 633 Prairie Pkwy, Fond Du Lac, WI 54935 | 2017-05-11 |
| 1467856336 | Chuentao Ho | Specialist/Technologist | 45 South National Ave., Fond Du Lac, WI 54935 | 2014-10-21 |
| 1437587961 | Paula Seeley | Nurse Practitioner | 63 West Pioneer Rd, Fond Du Lac, WI 54935 | 2013-10-18 |
| 1144516030 | Bonnie Kay Mallon | Registered Nurse | 118 E 9th St, Fond Du Lac, WI 54935 | 2011-06-20 |
| 1770885600 | Holly Shepard | Counselor | 23 W Scott St., Fond Du Lac, WI 54935 | 2010-11-29 |
| 1437479110 | Ruth Marie Bohn | Occupational Therapy Assistant | 244 North Macy Street, Fond Du Lac, WI 54935 | 2010-06-04 |
| Find all providers in zip 54935 | ||||
| Taxonomy Code | 273Y00000X |
| Grouping | Hospital Units |
| Classification | Rehabilitation Unit |
| In general, a distinct unit of a general acute care hospital that provides care encompassing a comprehensive array of restoration services for the disabled and all support services necessary to help patients attain their maximum functional capacity. Source: AHA Annual Survey p. A10 1996 AHA Guide. For Medicare, a distinct part of a general acute care hospital providing inpatient rehabilitation services that meets the following requirements. Rehabilitation Units have in effect a preadmission screening procedure under which each prospective patient’s condition and medical history are reviewed to determine whether the patient is likely to benefit significantly from an intensive inpatient program or assessment; ensure that the patients receive close medical supervision and furnish, through the use of qualified personnel, rehabilitation nursing, physical therapy and occupational therapy, plus, as needed, speech therapy, social services or psychological services and orthotic and prosthetic services; have a plan of treatment for each inpatient that is established, reviewed, and revised as needed by a physician in consultation with other professional personnel who provide services to the patient; use a coordinated multidisciplinary team approach in the rehabilitation of each inpatient, as documented by periodic clinical entries made in the patient’s medical record to note the patient's status in relationship to goal attainment, and that team conferences are held at least every two weeks to determine the appropriateness of treatment; have a director of rehabilitation who provides services to the unit and its inpatients for at least 20 hours a week, is a doctor of medicine or osteopathy, is licensed under State law to practice medicine or surgery, and has had, after completing a one-year hospital internship at least two years of training or experience in the medical management of inpatients requiring rehabilitation services. |
| Notes: Source: Code of Federal Regulations #42, Section 412.29. |
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| 1588104475 | Mchs Hospitals, Inc. | Rehabilitation Unit | 611 N Saint Joseph Ave, Marshfield, WI 54449-1832 | 2017-02-27 |
| 1801294905 | Rennes Health and Rehab Center | Rehabilitation Unit | 1970 Navajo St, Rhinelander, WI 54501-8890 | 2014-12-05 |
| 1124463815 | Aurora Medical Center Grafton | Rehabilitation Unit | 975 Port Washington Rd, Grafton, WI 53024-9201 | 2013-05-08 |
| 1871815282 | Aurora Health Care Southern Lakes, Inc. | Rehabilitation Unit | 36500 Aurora Dr, Summit, WI 53066-4899 | 2010-02-26 |
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| City | FOND DU LAC |
| Zip Code | 54935 |
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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.