DIVINE SAVIOR HEALTHCARE INC. (NPI# 1750514618) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750514618 |
| Entity Type | Organization |
| Organization Name | DIVINE SAVIOR HEALTHCARE INC. |
| Practice Address |
2817 New Pinery Rd Portage WI 53901-9240 |
| Mailing Address |
6501 City West Pkwy Eden Prairie MN 55344-3248 |
| Practice Telephone | 6087424131 |
| Enumeration Date | 2009-08-26 |
| Last Update Date | 2009-08-26 |
| Authorized Official Name | MICHAEL DECKER (PRESIDENT) |
| Authorized Official Telephone | 9526532528 |
| Is Organization Subpart | Y |
| Parent Organization Name | DIVINE SAVIOR HEALTHCARE INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332900000X | Non-Pharmacy Dispensing Site | Suppliers |
| Street Address |
2817 NEW PINERY RD |
| City | PORTAGE |
| State | WI |
| Zip Code | 53901-9240 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174506307 | James T Gariti Sr. | Emergency Medicine | 2817 New Pinery Rd, Divine Savior Healthcare Inc, Portage, WI 53901-9257 | 2005-11-22 |
| 1881208635 | Sophie M Tessner | Pharmacist | 2817 New Pinery Rd, Portage, WI 53901-9240 | 2020-08-31 |
| 1164047015 | Stephanie Jo Holt | Nurse Practitioner | 2817 New Pinery Rd, Portage, WI 53901-9240 | 2020-06-16 |
| 1770132268 | Anna Carole Hormig | Registered Nurse | 2817 New Pinery Rd, Portage, WI 53901-9240 | 2019-09-06 |
| 1790338655 | Andrea Olsen | Occupational Therapist | 2817 New Pinery Rd, Portage, WI 53901-9240 | 2019-07-19 |
| 1316590417 | Nicole Rae Sletten | Occupational Therapy Assistant | 2817 New Pinery Rd, Portage, WI 53901-9240 | 2019-07-18 |
| 1851944078 | Andrew Larson | Physical Therapist | 2817 New Pinery Rd, Portage, WI 53901-9240 | 2019-07-17 |
| 1780236067 | Danielle Debruyne | Physical Therapist | 2817 New Pinery Rd, Portage, WI 53901-9240 | 2019-07-16 |
| 1063077055 | Dillon Via | Physician Assistant | 2817 New Pinery Rd, Portage, WI 53901-9240 | 2019-05-06 |
| 1659843886 | Andrew Benton Padley | Registered Nurse | 2817 New Pinery Rd, Portage, WI 53901-9240 | 2018-12-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740710748 | Robert James Corliss | Internal Medicine | St. Vincent Fmc, 140east Cook St., Portage, WI 53901 | 2017-06-13 |
| 1639328867 | Casey Jo Ambort | Speech-Language Pathologist | 626 East Slifer St, Portage, WI 53901 | 2008-09-11 |
| 1871767400 | Planned Parenthood of Wi, Inc | Non-Pharmacy Dispensing Site | 132 W. Cook St., Portage, WI 53901 | 2008-04-15 |
| 1881872158 | Marta Jean Jindra | Physical Therapist | 626 E Slifer Street, Portage, WI 53901 | 2008-02-08 |
| 1699953976 | Lana Marie Edwards | Speech-Language Pathologist | 626 East Slifer Street, Portage, WI 53901 | 2008-02-08 |
| 1134314552 | Kristina Hellenbrand | Physical Therapist | 2639 New Pinery Road, Suite 2, Portage, WI 53901 | 2007-09-10 |
| 1689727810 | Gregory Allan Bindl | Chiropractor | 2121new Pinery Rd, Portage, WI 53901 | 2007-01-19 |
| 1720149156 | Timothy J Rosin Dds Sc | Dentist | 2570 New Pinery Rd, Portage, WI 53901 | 2006-12-12 |
| 1710083779 | Currani Seubert Dental Office LLC | Dentist | 260 W Cook St, Portage, WI 53901 | 2006-09-16 |
| 1225090525 | University of Wisconsin Medical Foundation Inc | Durable Medical Equipment & Medical Supplies | 2977 Cty Hwy Cx, Portage, WI 53901 | 2006-04-04 |
| Find all providers in zip 53901 | ||||
| Taxonomy Code | 332900000X |
| Grouping | Suppliers |
| Classification | Non-Pharmacy Dispensing Site |
| A site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.) |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871767400 | Planned Parenthood of Wi, Inc | Non-Pharmacy Dispensing Site | 132 W. Cook St., Portage, WI 53901 | 2008-04-15 |
| 1376974451 | Divine Savior Healthcare Inc | Non-Pharmacy Dispensing Site | 2817 New Pinery Rd, Portage, WI 53901-9240 | 2013-11-27 |
| 1821130535 | Conemaugh Health Initiatives | Non-Pharmacy Dispensing Site | 3670 Portage St, Suite 105, Portage, PA 15946-6546 | 2007-02-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477188100 | Froedtert & The Medical College of Wisconsin Community Physicians Inc | Non-Pharmacy Dispensing Site | 635 S 28th St, Milwaukee, WI 53215-1201 | 2020-03-03 |
| 1841845385 | Planned Parenthood of Wisconsin | Non-Pharmacy Dispensing Site | 223 South Main St., Blair, WI 54616 | 2019-08-01 |
| 1982258737 | Planned Parenthood of Wisconsin | Non-Pharmacy Dispensing Site | 919 Hoeschler Dr Ste 100, Sparta, WI 54656-2202 | 2019-07-30 |
| 1780142992 | Froedtert & The Medical College of Wisconsin Community Physicians | Non-Pharmacy Dispensing Site | 11040 N Range Line Rd, Mequon, WI 53092-4930 | 2019-03-06 |
| 1992284087 | Froedtert & The Medical College of Wisconsin Community Physicians | Non-Pharmacy Dispensing Site | 4859 South 60th Street, Greenfield, WI 53220 | 2018-08-09 |
| 1801373378 | Froedtert & The Medical College of Wisconsin Community Physicians | Non-Pharmacy Dispensing Site | 1721 W Canal St, Milwaukee, WI 53233 | 2018-07-26 |
| 1205355500 | Froedtert Health | Non-Pharmacy Dispensing Site | 4850 S 60th St, Greenfield, WI 53220-4616 | 2017-09-18 |
| 1790071637 | St Mary's Hospital Medical Center | Non-Pharmacy Dispensing Site | 2840 Okeeffe Ave, Sun Prairie, WI 53590-7077 | 2011-06-20 |
| 1629390729 | Jt Medical Services, Inc. | Non-Pharmacy Dispensing Site | 12855 West Lisbon Road, 2nd Floor, Brookfield, WI 53005 | 2010-02-17 |
| 1013243294 | Barron County Office On Aging | Non-Pharmacy Dispensing Site | 335 E. Monroe Avenue, Room 112, Barron, WI 54812-1478 | 2009-10-23 |
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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.