BEAVER DAM COMMUNITY HOSPITALS, INC (NPI# 1750451142) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750451142 |
| Entity Type | Organization |
| Organization Name | BEAVER DAM COMMUNITY HOSPITALS, INC |
| Other Organization Name | HILLSIDE MANOR NURSING HOME |
| Practice Address |
707 S University Ave Beaver Dam WI 53916 |
| Mailing Address |
707 S University Ave Beaver Dam WI 53916-3027 |
| Practice Telephone | 9208877181 |
| Practice Fax Number | 9208873040 |
| Mailing Telephone | 9208877181 |
| Mailing Fax Number | 9208873040 |
| Enumeration Date | 2006-11-09 |
| Last Update Date | 2020-01-14 |
| Authorized Official Name | JOSEPH GILENE (INTERIM CAO) |
| Authorized Official Telephone | 9208877181 |
| Authorized Official Credential | FACHE |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 20146900 | 05 |
| Other Name | Type Code |
|---|---|
| HILLSIDE MANOR NURSING HOME | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366833394 | Beaver Dam Community Hospitals, Inc | Surgery | 705 S University Ave Ste 350, Beaver Dam, WI 53916 | 2015-02-12 |
| 1629374780 | Beaver Dam Community Hospitals, Inc | Family Medicine | 180 Gateway Dr, Waupun, WI 53963 | 2011-02-07 |
| 1508184896 | Beaver Dam Community Hospitals, Inc | Clinic/Center | 705 S University Ave Ste 360, Beaver Dam, WI 53916-3080 | 2010-05-11 |
| 1023310034 | Beaver Dam Community Hospitals, Inc | Family Medicine | 705 S University Ave Ste 150, Beaver Dam, WI 53916 | 2010-11-23 |
| 1942361134 | Beaver Dam Community Hospitals, Inc | Durable Medical Equipment & Medical Supplies | 707 S University Ave, Beaver Dam, WI 53916 | 2006-12-12 |
| 1023187416 | Beaver Dam Community Hospitals, Inc | General Acute Care Hospital | 707 S University Ave, Beaver Dam, WI 53916 | 2006-11-07 |
| 1962463760 | Beaver Dam Community Hospitals, Inc | Hospice Care, Community Based | 707 S University Ave, Beaver Dam, WI 53916 | 2006-03-31 |
| 1487615829 | Beaver Dam Community Hospitals, Inc | Home Health | 707 S University Ave, Beaver Dam, WI 53916 | 2006-03-28 |
| Street Address |
707 S UNIVERSITY AVE |
| City | BEAVER DAM |
| State | WI |
| Zip Code | 53916 |
| 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 | 314000000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Skilled Nursing Facility |
| (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis. |
| Notes: Source: (1) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 64; (2) AHA Guide, 1996 Annual Survey. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669543716 | Beaver Dam Nursing & Rehab Center, Inc | Skilled Nursing Facility | 1595 Us Highway 231 S, Beaver Dam, KY 42320-9463 | 2006-11-12 |
| 1134179849 | Ggnsc Beaver Dam LLC | Skilled Nursing Facility | 410 Roedl Ct, Beaver Dam, WI 53916-2934 | 2006-05-11 |
| 1679124705 | Bedrock Hcs At Beaver Dam LLC | Skilled Nursing Facility | 410 Roedl Ct, Beaver Dam, WI 53916-2934 | 2019-09-20 |
| 1992257109 | Dycora Transitional Health - Beaver Dam LLC | Skilled Nursing Facility | 410 Roedl Ct, Beaver Dam, WI 53916-2934 | 2016-11-04 |
| 1538321781 | Beaver Dam Health Care Manor Inc | Skilled Nursing Facility | 1595 Us Highway 231 S, Beaver Dam, KY 42320-9463 | 2008-06-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356962369 | Heritage Assisted Living, LLC | Skilled Nursing Facility | 5020 S 107th St, Greenfield, WI 53228-3267 | 2020-04-30 |
| 1235762881 | Imr Oak Creek Opco, LLC | Skilled Nursing Facility | 2700 West Honadel Boulevard, Oak Creek, WI 53154 | 2020-02-21 |
| 1831693936 | Golden Years Nursing Home, Inc. | Skilled Nursing Facility | 611 Harmony Dr, Lake Geneva, WI 53147-8800 | 2018-03-22 |
| 1801302732 | Oak Park Place of Janesville, LLC | Skilled Nursing Facility | 700 Myrtle Way, Janesville, WI 53545-9101 | 2017-12-14 |
| 1235674839 | Zachary Rader | Skilled Nursing Facility | 645 N Church St, Elkhorn, WI 53121-2204 | 2017-01-05 |
| 1982155248 | The Bethany-st. Joseph Corporation D/b/a Prairie Pointe Rehab Suites | Skilled Nursing Facility | 286 N. Willson Dr, Altoona, WI 54720 | 2016-10-20 |
| 1316492317 | Darcy Christiansen | Skilled Nursing Facility | 4427 E Pic A Dilly Dr, Janesville, WI 53546-9606 | 2016-08-19 |
| 1366895583 | Jeffrey Alan Weinshrott | Skilled Nursing Facility | 336 Wisconsin Ave, Sheboygan, WI 53081-4183 | 2016-07-22 |
| 1720433378 | Kendra Meyers | Skilled Nursing Facility | 1806 N Hume Ave Apt 4, Marshfield, WI 54449-1677 | 2016-05-02 |
| 1952756991 | Grace Lutheran Foundation Inc | Skilled Nursing Facility | 206 North Willson Drive, Altoona, WI 54720 | 2016-04-27 |
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| 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.