BEAVER DAM COMMUNITY HOSPITAL (NPI# 1720202864) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720202864 |
| Entity Type | Organization |
| Organization Name | BEAVER DAM COMMUNITY HOSPITAL |
| Other Organization Name | HILLSIDE UNIT PHARMACY |
| Practice Address |
707 S University Ave Beaver Dam WI 53916-3027 |
| Practice Telephone | 9208874146 |
| Practice Fax Number | 9208876613 |
| Mailing Telephone | 9208874146 |
| Mailing Fax Number | 9208870040 |
| Enumeration Date | 2007-04-12 |
| Last Update Date | 2019-02-18 |
| Authorized Official Name | KIM MILLER (PRESIDENT AND CEO) |
| Authorized Official Telephone | 9208874066 |
| Authorized Official Credential | FACHE |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 282N00000X | General Acute Care Hospital | 5344-042 | WV | Hospitals |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | STATE LICENSE # | 5344-042 | 01 |
| WI | WI MEDICAID NUMBER | 5111923 | 01 |
| WI | NABP NUMBER | 5111923 | 01 |
| WI | DEA # | AB5024322 | 01 |
| Other Name | Type Code |
|---|---|
| Hillside Unit Pharmacy | Doing Business As Name - Organization |
| Street Address |
707 S UNIVERSITY AVE |
| City | BEAVER DAM |
| State | WI |
| Zip Code | 53916-3027 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316941701 | Mary Ann Chambers | Nurse Practitioner | 707 S University Ave, Beaver Dam, WI 53916-3027 | 2005-06-13 |
| 1851901466 | Quest Diagnostics LLC Il | Pathology | 707 S University Ave, Beaver Dam, WI 53916-3027 | 2020-08-07 |
| 1700350683 | Devyn Beaugh | Pharmacist | 707 S University Ave, Beaver Dam, WI 53916-3027 | 2019-01-14 |
| 1871091207 | Ryan Patrick Gallagher | Physician Assistant | 707 S University Ave, Beaver Dam, WI 53916-3027 | 2018-01-31 |
| 1992212062 | Beaver Dam Community Hospitals Inc | Internal Medicine | 707 S University Ave, Wound Clinic, Beaver Dam, WI 53916 | 2018-01-10 |
| 1720590763 | Ellen Joyce Ellingsworth | Dietitian, Registered | 707 S University Ave, Beaver Dam, WI 53916-3027 | 2017-10-31 |
| 1265984413 | Kayla Sharpee | Physical Therapist | 707 S University Ave, Beaver Dam, WI 53916-3027 | 2016-11-03 |
| 1427506096 | Jami Nicole Burg | Physician Assistant | 707 S University Ave, Beaver Dam, WI 53916-3027 | 2016-09-13 |
| 1619420932 | Caleb Mabis | Physician Assistant | 707 S University Ave, Beaver Dam, WI 53916-3027 | 2016-08-03 |
| 1245680511 | Benjamin Williams | Physical Therapist | 707 S University Ave, Beaver Dam, WI 53916-3027 | 2016-06-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538718283 | Paulette Neibauer | Technician | N7262 Farwell Rd., Beaver Dam, WI 53916 | 2019-09-05 |
| 1902336597 | Tricounty Homecare Inc | In Home Supportive Care | 140 Corporate Dr Ste 2, Beaver Dam, WI 53916 | 2017-06-15 |
| 1528502754 | Jessica Marie Blatz | Counselor | 809 Park Aveune, Beaver Dam, WI 53916 | 2016-12-07 |
| 1376090886 | Beaver Dam Hearing Care, LLC | Hearing Aid Equipment | 705 University Ave, Suite 170, Beaver Dam, WI 53916 | 2016-09-01 |
| 1275902546 | Beaver Dam Community Hospitals Inc | Pharmacy | 705 S University Ave Ste 180, Beaver Dam, WI 53916 | 2015-09-17 |
| 1609242825 | Tami Joe Delisle | Counselor | 207 North Spring Street, Beaver Dam, WI 53916 | 2015-08-12 |
| 1366833394 | Beaver Dam Community Hospitals, Inc | Surgery | 705 S University Ave Ste 350, Beaver Dam, WI 53916 | 2015-02-12 |
| 1326471608 | Raquel Rodriguez-guzman | Pharmacist | 205 La Crosse Street, Beaver Dam, WI 53916 | 2013-08-09 |
| 1558608828 | Mary Y Kunz | Licensed Practical Nurse | 6550 N Highway 151 Lot 63, Beaverdam, WI 53916 | 2013-01-07 |
| 1881938454 | Brock Holden Slinger | Physical Therapist | 205 Monroe St. #13, Beaver Dam, WI 53916 | 2012-11-20 |
| Find all providers in zip 53916 | ||||
| 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 |
|---|---|---|---|---|
| 1023187416 | Beaver Dam Community Hospitals, Inc | General Acute Care Hospital | 707 S University Ave, Beaver Dam, WI 53916 | 2006-11-07 |
| 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 |
| Find all providers with the same taxonomy | ||||
| City | BEAVER DAM |
| Zip Code | 53916 |
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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.