ST. MARY'S HOSPITAL (NPI# 1619305703) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619305703 |
| Entity Type | Organization |
| Organization Name | ST. MARY'S HOSPITAL |
| Practice Address |
1726 Shawano Ave Green Bay WI 54303-3216 |
| Practice Telephone | 9204984267 |
| Enumeration Date | 2013-10-29 |
| Last Update Date | 2013-10-29 |
| Authorized Official Name | THERESE B. PANDL (PRESIDENT AND CHIEF EXECUTIVE OFFIC) |
| Authorized Official Telephone | 9208845801 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2000X |
Clinic/Center Specialization: Physical Therapy |
1193624 | WI | Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992931232 | St. Mary's Hospital | Early Intervention Provider Agency | 9226 Avenue J, Brooklyn, Brooklyn, NY 11236-3935 | 2009-06-01 |
| 1932333994 | St. Mary's Hospital | Physical Therapist | 619 4th St, Kamiah, ID 83636 | 2009-05-06 |
| 1427261007 | St. Mary's Hospital | General Acute Care Hospital | 365 Harding Ave, Apt. 2, Clifton, NJ 07011-3626 | 2007-05-08 |
| 1578684023 | St. Mary's Hospital | Community Based Residential Treatment Facility, Mental Illness | 530 Main Ave, Passaic, NJ 07055-5700 | 2007-04-03 |
| 1750402202 | St. Mary's Hospital | Residential Treatment Facility, Emotionally Disturbed Children | 33 Mineral Spring Ave, Passaic, NJ 07055-2512 | 2007-04-03 |
| 1366480394 | St. Mary's Hospital | Nurse Practitioner | 501 Oak, Nezperce, ID 83543 | 2006-06-03 |
| 1568400562 | St. Mary's Hospital | Nurse Practitioner | 518 Oak, Kamiah, ID 83536 | 2006-06-02 |
| 1770521817 | St. Mary's Hospital | Nurse Practitioner | 320 N Division, Craigmont, ID 83523 | 2006-06-02 |
| 1285630624 | St. Mary's Hospital | Clinic/Center | 205 Huron, Irvington, IL 62848 | 2005-06-21 |
| 1790789451 | St. Mary's Hospital | Clinic/Center | 825 New York Dr, Ste 2, Vandalia, IL 62471-1044 | 2005-06-10 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | ST MARY'S HOSPITAL FOR CHILDREN, INC. | 2901 216th St, Bayside, NY 11360-2810 |
| System for Award Management (SAM) Entities | ST MARY'S HOSPITAL MEDICAL CENTER | 700 S Park St, Madison, WI 53715-1849 |
| System for Award Management (SAM) Entities | ST MARY'S HOSPITAL OF SUPERIOR | 3500 Tower Ave, Superior, WI 54880-5335 |
| Colorado Business Entities | St. Mary's Hospital & Medical Center Medical Staff | 2635 N 7th St, Grand Junction, CO 81501 |
| Washington State Corporations | ST. MARY'S HOSPITAL & MEDICAL CENTER, INC. | 500 Eldorado Blvd Ste 4300, Attn Chief Legal Officer, Broomfield, CO 80021 |
| Colorado Business Entities | ST. MARY'S HOSPITAL & MEDICAL CENTER, INC. | 2635 N. 7th Street, Grand Junction, CO 81501 |
| Colorado Business Entities | ST. MARY'S HOSPITAL FOUNDATION | 2635 N 7th Street, Grand Junction, CO 81501 |
| System for Award Management (SAM) Entities | ST. MARY'S HOSPITAL FOUNDATION | 2635 N 7th St, Grand Junction, CO 81501-8209 |
| System for Award Management (SAM) Entities | ST. MARY'S HOSPITAL LACOR | Juba Road, Gulu, , UGA |
| Massachusetts Corporations | ST. MARY'S HOSPITAL, INC. | 901 45th St., W. Palm Beach, FL 33416 |
| Street Address |
1726 SHAWANO AVE |
| City | GREEN BAY |
| State | WI |
| Zip Code | 54303-3216 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356324990 | Thomas M. Farley | Anesthesiology | 1726 Shawano Ave, Green Bay, WI 54303-3216 | 2005-11-29 |
| 1265048805 | Hillary Ann Bashaw | Nurse Practitioner | 1726 Shawano Ave, Green Bay, WI 54303-3216 | 2020-09-18 |
| 1043828387 | St Mary's Hospital Medical Center of Green Bay Inc.-hospital Sisters | Clinical Medical Laboratory | 1726 Shawano Ave, Green Bay, WI 54303-3282 | 2020-07-22 |
| 1750930079 | Jenna Mae Spude | Nurse Practitioner | 1726 Shawano Ave, Green Bay, WI 54303-3216 | 2019-09-09 |
| 1215423504 | Matthew James Dolan | Physician Assistant | 1726 Shawano Ave, Green Bay, WI 54303 | 2018-07-10 |
| 1013430073 | Whitney Jo Brusich | Physician Assistant | 1726 Shawano Ave, Green Bay, WI 54303-3216 | 2017-07-21 |
| 1720510043 | Christina R Mestelle | Physical Therapist | 1726 Shawano Ave, Green Bay, WI 54303 | 2017-03-28 |
| 1407231178 | Ahmed Farouk Mohammed | Internal Medicine | 1726 Shawano Ave, Green Bay, WI 54303-3216 | 2015-07-23 |
| 1184004236 | St. Vincent Hospital-hospital Sisters-third Order of St. Francis | Internal Medicine | 1726 Shawano Ave, Green Bay, WI 54303-3216 | 2015-06-04 |
| 1629468343 | Lynn Wilson | Nurse Practitioner | 1726 Shawano Ave, Green Bay, WI 54303-3216 | 2015-02-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952921033 | Ashley Marie Vandermoss | Social Worker | 1601 W Mason Street, Green Bay, WI 54303 | 2020-04-20 |
| 1598307423 | Jean Marie Castaneda | Case Manager/Care Coordinator | 2517 N. Court, Green Bay, WI 54303 | 2019-10-11 |
| 1215579552 | Integrated Treatment Centers, LLC | Clinic/Center | 2311 W Mason Street, Green Bay, WI 54303 | 2019-10-08 |
| 1003460551 | Affordable Dentures & Implants - Green Bay, S.c. | Dentist | 1800-c W. Mason Street, Green Bay, WI 54303 | 2019-08-01 |
| 1164940375 | Kaeley Rae Blaney | Student in an Organized Health Care Education/Training Program | 2088 Memorial Drive #208, Green Bay, WI 54303 | 2017-09-07 |
| 1518498047 | Treatment Providers LLC | Clinic/Center | 2731 N Packerland Dr Ste A, Green Bay, WI 54303 | 2017-03-26 |
| 1851840565 | Back To Balance Chiropractic, LLC | Chiropractor | 110 Packerland Drive, Suite B, Green Bay, WI 54303 | 2016-09-23 |
| 1710361001 | Matthew Lemay | Acupuncturist | 727 E Walnut, Suite B2, Green Bay, WI 54303 | 2015-07-16 |
| 1144600149 | Carrie Jean Banaszak | Counselor | 1039 Mason Street, Green Bay, WI 54303 | 2015-06-04 |
| 1174921993 | Kensey Meyer | Occupational Therapy Assistant | 1555 Dousman Road, Seymour, WI 54303 | 2014-12-10 |
| Find all providers in zip 54303 | ||||
| Taxonomy Code | 261QP2000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Physical Therapy |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639410434 | Renew Physical Therapy, Inc | Clinic/Center | 2701 Larsen Rd, Suite 111, Green Bay, WI 54303-4863 | 2013-03-05 |
| 1700068590 | Andresource, LLC | Clinic/Center | 1050 Circle Dr, Suite B, Green Bay, WI 54304-5568 | 2007-12-04 |
| 1992808166 | Bellin Health Physical Therapy Obgyn | Clinic/Center | 1537 Park Pl Ste 200, Green Bay, WI 54304-1974 | 2006-09-06 |
| 1194742692 | St Vincent Hospital-hospital Sisters-third Order of St Francis | Clinic/Center | 1821 S Webster Ave, Green Bay, WI 54301-2253 | 2006-07-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093313074 | Byond Physical Therapy, LLC | Clinic/Center | 11320 W Forest Home Ave, Franklin, WI 53132-1401 | 2020-10-13 |
| 1568078780 | Streamline Physical Therapy | Clinic/Center | 5806 Crabapple Ln, Madison, WI 53711-3437 | 2020-09-22 |
| 1790311199 | Exos Wi LLC | Clinic/Center | 7044 S Ballpark Dr Ste 300, Franklin, WI 53132-6910 | 2020-03-17 |
| 1831735885 | Garvey Physical Therapy & Wellness LLC | Clinic/Center | 417 Maple Ct, Campbellsport, WI 53010-3531 | 2019-11-25 |
| 1821649088 | Impact Physical Therapy & Performance LLC | Clinic/Center | 1155 Clarity Dr, Verona, WI 53593-9318 | 2019-09-27 |
| 1427605146 | Peak Endurance | Clinic/Center | 15 N Butler St, Madison, WI 53703-4237 | 2019-08-19 |
| 1558917617 | Quad/med, LLC | Clinic/Center | N61 W23044 Harry's Way, Sussex, WI 53089 | 2019-08-14 |
| 1619521267 | Space To Be Well, LLC | Clinic/Center | 1091 Sutherland Ave, River Falls, WI 54022-7509 | 2019-07-31 |
| 1346894656 | Cornerstone Physical Therapy, LLC | Clinic/Center | 2829 County Highway I Ste 3, Chippewa Falls, WI 54729-2678 | 2019-07-25 |
| 1619437514 | Resilience Rx LLC | Clinic/Center | 4708 Graywood Ct Apt 3, Nashotah, WI 53058-9688 | 2019-03-25 |
| 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.