ST. LUKE'S HOSPITAL OF DULUTH (NPI# 1629017793) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1629017793 |
Entity Type | Organization |
Organization Name | ST. LUKE'S HOSPITAL OF DULUTH |
Other Organization Name | MARINER OUTPATIENT SURGERY CENTER |
Practice Address |
109 N 28th St E Superior WI 54880-6548 |
Practice Telephone | 7153953900 |
Mailing Telephone | 7153953900 |
Enumeration Date | 2006-06-05 |
Last Update Date | 2020-01-28 |
Authorized Official Name | MR. KEVIN NOKELS (PRESIDENT, CEO) |
Authorized Official Telephone | 2182495389 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 208600000X | Surgery | Allopathic & Osteopathic Physicians | ||
N | 261QA1903X |
Clinic/Center Specialization: Ambulatory Surgical |
Ambulatory Health Care Facilities | ||
Y | 282N00000X | General Acute Care Hospital | Hospitals |
Other Name | Type Code |
---|---|
Mariner Outpatient Surgery Center | Doing Business As Name - Organization |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1497087126 | St. Luke's Hospital of Duluth | Family Medicine | 6351 E. Superior St., Duluth, MN 55804-2545 | 2010-02-05 |
1083668784 | St. Luke's Hospital of Duluth | Surgery | 920 E 1st St Ste 302, Duluth, MN 55805 | 2006-05-19 |
1063464154 | St. Luke's Hospital of Duluth | Family Medicine | 8373 Unity Drive, Virginia, MN 55792-4005 | 2006-05-17 |
1316999485 | St. Luke's Hospital of Duluth | Family Medicine | 2201 Lake Shore Drive East, Ashland, WI 54806-2331 | 2006-05-17 |
1952926206 | St. Luke's Hospital of Duluth | Durable Medical Equipment & Medical Supplies | 1012 E 2nd St, Duluth, MN 55805-2200 | 2020-06-12 |
1689200578 | St. Luke's Hospital of Duluth | Hospitalist | 915 E 1st St, Duluth, MN 55805-2193 | 2020-03-23 |
1336774165 | St. Luke's Hospital of Duluth | Durable Medical Equipment & Medical Supplies | 915 E 1st St, Duluth, MN 55805-2193 | 2020-03-12 |
1275005498 | St. Luke's Hospital of Duluth | Clinic/Center | 1000 E 1st St Ste 204, Duluth, MN 55805-2297 | 2018-12-28 |
1205319662 | St. Luke's Hospital of Duluth | Durable Medical Equipment & Medical Supplies | 930 E 2nd St, Duluth, MN 55805-2104 | 2018-09-12 |
1528505955 | St. Luke's Hospital of Duluth | Internal Medicine | 1001 E Superior St, Ste. L201, Duluth, MN 55802-2207 | 2017-01-24 |
Entity Type | Entity Name | Entity Address |
---|---|---|
System for Award Management (SAM) Entities | ST. LUKE'S HOSPITAL OF DULUTH | 915 E First St, Duluth, MN 55805-2107 |
Street Address |
109 N 28TH ST E |
City | SUPERIOR |
State | WI |
Zip Code | 54880-6548 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1760449763 | Lauren Elizabeth Giammar | Family Medicine | 109 N 28th St E, Superior, WI 54880-6548 | 2006-04-26 |
1013351279 | Megan J Hoel | Family Medicine | 109 N 28th St E, Superior, WI 54880-6548 | 2013-04-18 |
1841212487 | Brian G Riddle | Family Medicine | 109 N 28th St E, Superior, WI 54880-6548 | 2006-07-24 |
1528010667 | St. Luke's Hospital of Duluth | Ophthalmology | 109 N 28th St E, Superior, WI 54880-6548 | 2006-05-17 |
1790736981 | Anna Charlotte Greiner | Physician Assistant | 109 N 28th St E, Superior, WI 54880 | 2006-05-13 |
1114978236 | Jon Charles Stephenson | Family Medicine | 109 N 28th St E, Superior, WI 54880-6548 | 2006-05-13 |
1386695401 | Sonja Ursula Swenson | Family Medicine | 109 N 28th St E, Superior, WI 54880-6548 | 2006-05-13 |
1598716953 | Robert Lovell Sellers | Family Medicine | 109 N 28th St E, Superior, WI 54880-6548 | 2006-05-12 |
1609826452 | John Sukhoon Yoon | Ophthalmology | 109 N 28th St E, Superior, WI 54880-6548 | 2006-05-11 |
1649220344 | Ronald A Warcholak | Podiatrist | 109 N 28th St E, Superior, WI 54880-6548 | 2006-05-11 |
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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 |
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Taxonomy Code | 282N00000X |
Grouping | Hospitals |
Classification | General Acute Care Hospital |
An acute general hospital is an institution whose primary function is to provide inpatient diagnostic and therapeutic services for a variety of medical conditions, both surgical and non-surgical, to a wide population group. The hospital treats patients in an acute phase of illness or injury, characterized by a single episode or a fairly short duration, from which the patient returns to his or her normal or previous level of activity. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1255938510 | Ascension Wisconsin Emerus Menomonee Falls, LLC | General Acute Care Hospital | 4935 S 76th St Ste 100, Milwaukee, WI 53220-4305 | 2020-10-08 |
1225635592 | Ascension Wisconsin Emerus Menomonee Falls, LLC | General Acute Care Hospital | 2304 W Saint Paul Ave Ste 100, Waukesha, WI 53188-5942 | 2020-10-08 |
1740805423 | Froedtert Health Neighborhood Hospital, LLC | General Acute Care Hospital | 209 Pewaukee Rd, Pewaukee, WI 53072 | 2020-06-09 |
1952921405 | Aspirus Wausau Hospital, Inc | General Acute Care Hospital | 2720 Plaza Dr Ste 1400, Wausau, WI 54401-4166 | 2020-04-24 |
1376197665 | Mchs Hospitals, Inc. | General Acute Care Hospital | 9576 Highway 70, Minocqua, WI 54548 | 2019-07-25 |
1952809816 | Mchs Hospitals, Inc. | General Acute Care Hospital | 2310 Craig Rd, Eau Claire, WI 54701-6128 | 2018-01-25 |
1003349028 | Ditte Primdahl | General Acute Care Hospital | 1685 Highland, Madison, WI 53705-2281 | 2017-04-06 |
1194278952 | Aurora Health Care | General Acute Care Hospital | 9200 W Loomis Rd Ste 107, Franklin, WI 53132-9621 | 2016-07-28 |
1093171498 | Mchs Hospitals, Inc. | General Acute Care Hospital | 1001 N. Oak Ave, Marshfield, WI 54449 | 2016-01-14 |
1841656188 | Wheaton Franciscan Home Health | General Acute Care Hospital | 4300 Brown Deer Road, Brown Deer, WI 53223-2410 | 2015-12-31 |
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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.