ST NICHOLAS HOSPITAL-SISTERS OF THIRD ORDER OF ST FRANCIS (NPI# 1659636108) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659636108 |
| Entity Type | Organization |
| Organization Name | ST NICHOLAS HOSPITAL-SISTERS OF THIRD ORDER OF ST FRANCIS |
| Other Organization Name | PREVEA HEALTH-PLYMOUTH DME SUPPLIER |
| Practice Address |
825 Walton Dr Plymouth WI 53073-5022 |
| Practice Telephone | 9208924322 |
| Mailing Telephone | 9208924322 |
| Enumeration Date | 2012-07-11 |
| Last Update Date | 2014-02-05 |
| Authorized Official Name | ANDREW J BAGNALL (PRESIDENT & CEO) |
| Authorized Official Telephone | 9204594705 |
| Is Organization Subpart | Y |
| Parent Organization Name | ST NICHOLAS HOSPITAL OF THE HOSPITAL SISTERS OF ST FRANCIS |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers |
| Other Name | Type Code |
|---|---|
| Prevea Health-Plymouth DME Supplier | Other Name - Individual/Organization |
| Street Address |
825 WALTON DR |
| City | PLYMOUTH |
| State | WI |
| Zip Code | 53073-5022 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013090455 | Jennifer Ann-gabrys Rench | Family Medicine | 825 Walton Dr, Plymouth, WI 53073-5022 | 2006-10-21 |
| 1619476256 | Angela Meg Montague | Nurse Practitioner | 825 Walton Dr, Plymouth, WI 53073-5022 | 2018-02-09 |
| 1669928495 | Amber Golembeski | Nurse Practitioner | 825 Walton Dr, Plymouth, WI 53073 | 2016-08-31 |
| 1205212214 | Heather Meeusen | Nurse Practitioner | 825 Walton Dr, Plymouth, WI 53073-5022 | 2015-08-03 |
| 1619379369 | Melissa Virant | Nurse Practitioner | 825 Walton Dr, Plymouth, WI 53073-5022 | 2014-09-24 |
| 1518214394 | Kristin Kaiser | Occupational Therapist | 825 Walton Dr, Plymouth, WI 53073-5022 | 2012-08-10 |
| 1407122708 | Alison J Zimmermann | Physical Therapist | 825 Walton Dr, Plymouth, WI 53073-5022 | 2012-03-30 |
| 1184919359 | Sarah A Wegner | Physical Therapist | 825 Walton Dr, Plymouth, WI 53073-5022 | 2011-06-15 |
| 1821136300 | Heidi Ann Butler | Counselor | 825 Walton Dr, Plymouth, WI 53073-5022 | 2007-02-05 |
| 1508943929 | Deanna Lyons | Chiropractor | 825 Walton Dr, Plymouth, WI 53073-5022 | 2006-11-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245889914 | Patricia M. Stone | Technician | 440 Stoneybrook Lane, Plymouth, WI 53073 | 2019-09-05 |
| 1801387501 | Kwon Yang | Dentist | W 9071 Forest Drive, Plymouth, WI 53073 | 2018-05-29 |
| 1396258752 | Advanced Dental Care Clinic Sc | Clinic/Center | 62 S Pleasant View Road, Plymouth, WI 53073 | 2017-11-08 |
| 1164888004 | Lukresse Tatiana Kouam Tchuendem | Registered Nurse | 236 N Milwaukee St, Plymoth, WI 53073 | 2016-01-07 |
| 1831447424 | Lori Ann Schuette | Registered Nurse | 406 Summit Street, Plymouth, WI 53073 | 2012-08-29 |
| 1821360967 | Kristine Marie Van Ess | Case Manager/Care Coordinator | 7135 Rocky Knoll Pkwy, Plymouth, WI 53073 | 2012-02-06 |
| 1750699708 | Shannon Diamond | Physical Therapist | 825 Walton Drive, Plymouth, WI 53073 | 2010-09-23 |
| 1306088265 | Lacey Lyn Schafer | Nurse Practitioner | W9071 Forest Dr, Plymouth, WI 53073 | 2009-03-24 |
| 1275780868 | Stella D. Kaas-lallensack | Occupational Therapist | W5774 Garton Rd, Plymouth, WI 53073 | 2008-08-26 |
| 1912172248 | Judith A Nelson | Registered Nurse | N7116 County Road E, Plymouth, WI 53073 | 2008-04-28 |
| Find all providers in zip 53073 | ||||
| Taxonomy Code | 332B00000X |
| Grouping | Suppliers |
| Classification | Durable Medical Equipment & Medical Supplies |
| A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient’s use in the home and that are usable for an extended period of time. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922568302 | Lincare Inc | Durable Medical Equipment & Medical Supplies | 12800 Industrial Park Blvd Ste 140&155, Plymouth, MN 55441-3974 | 2019-03-22 |
| 1639689854 | Macomb Primary Care, P.c | Durable Medical Equipment & Medical Supplies | 851 South Main Street, Suite #3, Plymouth, MI 48170 | 2017-10-02 |
| 1295077725 | Emilou Gray Phelps | Durable Medical Equipment & Medical Supplies | 454 Us Highway 64 E, Plymouth, NC 27962-9593 | 2013-03-22 |
| 1437418134 | Ferris Enterprises, Inc. | Durable Medical Equipment & Medical Supplies | 1842 Magnolia Ln N, Plymouth, MN 55441-4024 | 2012-05-15 |
| 1346518933 | Cvs Manchester Nh, LLC | Durable Medical Equipment & Medical Supplies | 345 Highland St, Plymouth, NH 03264-3609 | 2011-12-09 |
| 1700187705 | Independent Medical Supply Comany | Durable Medical Equipment & Medical Supplies | 14486 Oxford, Plymouth, MI 48170-2674 | 2010-11-06 |
| 1669709572 | Bright Solutions | Durable Medical Equipment & Medical Supplies | 178 Halfway Pond Rd, Plymouth, MA 02360-3253 | 2009-11-13 |
| 1902039076 | Alla G. Vaynberg | Durable Medical Equipment & Medical Supplies | 10230 28th Ave N, Plymouth, MN 55441-3265 | 2009-08-24 |
| 1366680688 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 6025 Shenandoah Ln N, Plymouth, MN 55446 | 2009-01-23 |
| 1861641250 | Mayflower Mobility, Inc. | Durable Medical Equipment & Medical Supplies | 127 Camelot Dr, Suite 1, Plymouth, MA 02360-3039 | 2008-09-10 |
| Find all providers in PLYMOUTH | ||||
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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.