ST. MARY'S HOSPITAL OF SUPERIOR (NPI# 1588691588) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588691588 |
| Entity Type | Organization |
| Organization Name | ST. MARY'S HOSPITAL OF SUPERIOR |
| Other Organization Name | ESSENTIA HEALTH ST. MARY'S-SUPERIOR CLINIC |
| Practice Address |
3500 Tower Ave Superior WI 54880-5335 |
| Practice Telephone | 7158177100 |
| Practice Fax Number | 7153955433 |
| Mailing Telephone | 7158177100 |
| Mailing Fax Number | 7153955433 |
| Enumeration Date | 2006-06-26 |
| Last Update Date | 2020-04-01 |
| Authorized Official Name | KIM PEARSON (ADMINISTRATOR) |
| Authorized Official Telephone | 7158177017 |
| Is Organization Subpart | Y |
| Parent Organization Name | ST. MARY'S DULUTH CLINIC HEALTH SYSTEM |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QC0050X |
Clinic/Center Specialization: Critical Access Hospital |
5516-800 | WI | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 1588691588 | 05 |
| Other Name | Type Code |
|---|---|
| Essentia Health St. Mary's-Superior Clinic | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972710507 | St. Mary's Hospital of Superior | Medicare Defined Swing Bed Unit | 3500 Tower Ave, Superior, WI 54880-5335 | 2007-05-16 |
| 1700817079 | St. Mary's Hospital of Superior | Clinic/Center | 3500 Tower Ave, Superior, WI 54880-5335 | 2006-07-05 |
| 1083657886 | St. Mary's Hospital of Superior | Clinic/Center | 3500 Tower Ave, Superior, WI 54880-5335 | 2006-06-13 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | ST MARY'S HOSPITAL OF SUPERIOR | 3500 Tower Ave, Superior, WI 54880-5335 |
| Street Address |
3500 TOWER AVE |
| City | SUPERIOR |
| State | WI |
| Zip Code | 54880-5335 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801872080 | Vicki Brady | Nurse Practitioner | 3500 Tower Ave, Superior, WI 54880-5335 | 2005-12-19 |
| 1659911014 | Mary K Robinson | Social Worker | 3500 Tower Ave, Superior, WI 54880-4491 | 2020-01-13 |
| 1265093413 | Paige Lois Slemmons | Physical Therapist | 3500 Tower Ave, Superior, WI 54880-4491 | 2019-06-27 |
| 1164994513 | Elaina A Fischer | Nurse Practitioner | 3500 Tower Ave, Superior, WI 54880-4491 | 2018-12-26 |
| 1992229579 | Renee Christine Karth-pearson | Social Worker | 3500 Tower Ave, Superior, WI 54880-4491 | 2017-07-26 |
| 1821518267 | Ryan Morgan | Family Medicine | 3500 Tower Ave, Superior, WI 54880-4491 | 2017-06-27 |
| 1639699200 | Nicholas C. Ellefson | Family Medicine | 3500 Tower Ave, Superior, WI 54880-4491 | 2017-06-23 |
| 1760837819 | Eric James Estes | Physical Therapist | 3500 Tower Ave, Superior, WI 54880-4491 | 2016-04-26 |
| 1710352018 | Christina Drexler | Occupational Therapist | 3500 Tower Ave, Superior, WI 54880-5395 | 2015-12-11 |
| 1063881399 | The Duluth Clinic, Ltd. | Pharmacy | 3500 Tower Ave, Suite C, Superior, WI 54880-4685 | 2015-09-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104427194 | Alana Catherine Sullivan | Speech-Language Pathologist | 25 N 25th Street E, Superior, WI 54880 | 2020-11-05 |
| 1710524970 | Sean Wiberg Peterson | Specialist/Technologist | 1810 Catlin Ave, Room 1246, Superior, WI 54880 | 2019-12-06 |
| 1558858936 | Brent Adam Engstrom | Student in an Organized Health Care Education/Training Program | 1410 Nth 23rd Street, Superior, WI 54880 | 2018-04-20 |
| 1558769125 | David Kroll | Specialist | Balknap & Catlin Aves., Superior, WI 54880 | 2014-12-15 |
| 1154670321 | Superior Treatment Center, Inc | Community/Behavioral Health | 1507 Tower Ave Ste 307, Superior, WI 54880 | 2012-09-04 |
| 1548551658 | Dionne Jeannine Corcoran | Midwife | 916 Hammond Ave Ste 222, Superior, WI 54880 | 2011-04-22 |
| 1821235433 | Lauren Ashley Miller | Speech-Language Pathologist | 35 N. 28th Street, Superior, WI 54880 | 2009-01-20 |
| 1528261989 | Stacy Ann Kennelly | Physical Therapist | 1612 N 37th Street, Superior, WI 54880 | 2007-06-06 |
| 1760564942 | James Henry Dobis | Family Medicine | 3520 Tower Avenue, Twin Ports Va Outpatient Clinic, Superior, WI 54880 | 2006-10-19 |
| 1134214398 | Kevin M Mikel | Dentist | 3312 Tower Avenue, Superior, WI 54880 | 2006-10-04 |
| Find all providers in zip 54880 | ||||
| Taxonomy Code | 261QC0050X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Critical Access Hospital |
| An outpatient entity, facility, or distinct part of a facility within or affiliated with a Critical Access Hospital that provides access to primary care services for individuals in a small rural community and is Medicare certified. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356711816 | Jayne Elizabeth Rimer | Clinic/Center | 730 10th Ave, Baldwin, WI 54002-9416 | 2015-09-28 |
| 1467560227 | Ladd Memorial Hospital | Clinic/Center | 2600 65th Ave, Osceola, WI 54020-4370 | 2006-08-29 |
Please comment or provide details below to improve the information on ST. MARY'S HOSPITAL OF SUPERIOR.
| 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.