THEDACARE MEDICAL CENTER - BERLIN, INC. (NPI# 1760413777) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760413777 |
| Entity Type | Organization |
| Organization Name | THEDACARE MEDICAL CENTER - BERLIN, INC. |
| Other Organization Name | COMMUNITY HEALTH NETWORK, INC AND BERLIN MEMORIAL HOSPITAL |
| Practice Address |
225 Memorial Drive Berlin WI 54923-1243 |
| Mailing Address |
Po Box 2759 Appleton WI 54912-2759 |
| Practice Telephone | 9203611313 |
| Practice Fax Number | 9203615579 |
| Mailing Telephone | 9208305900 |
| Mailing Fax Number | 9208305910 |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2019-09-06 |
| Authorized Official Name | MR. MARK S THOMPSON (CHIEF FINANCIAL OFFICER) |
| Authorized Official Telephone | 9208305885 |
| Authorized Official Credential | CFO |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 282NC0060X |
General Acute Care Hospital Specialization: Critical Access |
Hospitals |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 11011000 | 05 |
| Other Name | Type Code |
|---|---|
| Community Health Network, Inc and Berlin Memorial Hospital | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023154929 | Thedacare Medical Center - Berlin, Inc. | Skilled Nursing Facility | 482 Oak St, Berlin, WI 54923-1204 | 2007-01-29 |
| 1447243399 | Thedacare Medical Center - Berlin, Inc. | Home Health | 402 Preston Lane, Redgranite, WI 54970 | 2005-08-25 |
| 1326493602 | Thedacare Medical Center - Berlin, Inc. | General Acute Care Hospital | 1080 W Fond Du Lac St, Ripon, WI 54971-9286 | 2016-04-25 |
| 1992159289 | Thedacare Medical Center - Berlin, Inc. | General Acute Care Hospital | N2930 State Road 22, Wautoma, WI 54982-5267 | 2016-04-22 |
| 1275943367 | Thedacare Medical Center - Berlin, Inc. | Anesthesiology | 225 Memorial Dr, Berlin, WI 54923-1243 | 2014-04-29 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | THEDACARE MEDICAL CENTER - BERLIN, INC. | 225 Memorial Dr, Berlin, WI 54923-1243 |
| Street Address |
225 MEMORIAL DRIVE |
| City | BERLIN |
| State | WI |
| Zip Code | 54923-1243 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942280821 | Dina N Nelson | Nurse Anesthetist, Certified Registered | 225 Memorial Drive, Anesthesia Dept, Berlin, WI 54923 | 2006-01-18 |
| 1750673513 | Kristy E Wagner | Occupational Therapy Assistant | 225 Memorial Drive, Berlin, WI 54923 | 2011-05-11 |
| 1376718692 | Mary F. Guell | Physical Therapist | 225 Memorial Drive, Rehab Department, Berlin, WI 54923 | 2008-04-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053910067 | Mary Ellen F Pumper | Pharmacist | 861 County Rd F, Berlin, WI 54923 | 2020-10-21 |
| 1962020792 | Brown Wilcox Trustees, Inc. | Home Health | 347 East Huron Street, Berlin, WI 54923 | 2020-07-08 |
| 1083050942 | Veterinary Clinic Berlin/ripon | Veterinarian | W1915 Cty Road F, Berlin, WI 54923 | 2013-05-20 |
| 1114078243 | David Earl Johanknecht | Optometrist | 269 Memorial Dr, Suite 103, Berlin, WI 54923 | 2007-01-16 |
| 1043314677 | William Harold Hastreiter | Dentist | 102 W Huron St, Berlin, WI 54923 | 2006-09-12 |
| 1699725333 | Kurt Alan Zemke | Dentist | 280 South Church St, Berlin, WI 54923 | 2006-05-11 |
| 1679574453 | Craig Batley | Family Medicine | W832 Hwy 91, Suite 3, Berlin, WI 54923 | 2005-08-03 |
| 1477043313 | Lina D Ramos | Registered Nurse | 225 Memorial Dr, Berlin, WI 54923 | 2018-05-16 |
| 1760887392 | Waushara Dental Associate Sc | Dentist | 322 Broadway, Berlin, WI 54923 | 2014-10-24 |
| 1700043205 | Ascension Medical Group-fox Valley Wisconsin, Inc | Clinic/Center | 225 Memorial Dr, Berlin, WI 54923 | 2008-05-21 |
| Find all providers in zip 54923 | ||||
| Taxonomy Code | 282NC0060X |
| Grouping | Hospitals |
| Classification | General Acute Care Hospital |
| Specialization | Critical Access |
| Definition to come. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346575560 | Androscoggin Valley Hospital Ob | General Acute Care Hospital | 59 Page Hill Rd, Berlin, NH 03570-3531 | 2009-10-06 |
| 1861568743 | Androscoggin Valley Hospital, Inc. | General Acute Care Hospital | 59 Page Hill Rd, Berlin, NH 03570-3531 | 2006-11-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710333893 | Thedacare Medical Center - Waupaca, Inc. | General Acute Care Hospital | N2610 Wi 22, Waupaca, WI 54981 | 2016-05-09 |
| 1255662573 | Donald Morris Levy | General Acute Care Hospital | 4348 W Tarrytown Ln, Mequon, WI 53092-4850 | 2010-01-26 |
| 1841483112 | Club Staffing | General Acute Care Hospital | 1082 Vinyard Dr, Oregon, WI 53575-3314 | 2007-08-21 |
| 1104953090 | New Anesthesia | General Acute Care Hospital | 1236 Stillmeadow Ln, Menasha, WI 54952-8920 | 2007-02-27 |
| 1184765240 | Tomah Memorial Hospital Inc | General Acute Care Hospital | 501 Gopher Dr, Tomah, WI 54660-4513 | 2007-02-10 |
| 1194737817 | Chippewa Valley Hospital & Oakview Care Center, Inc. | General Acute Care Hospital | 1220 3rd Ave W, Durand, WI 54736-1600 | 2006-08-12 |
| 1154350049 | Edgerton Hospital and Health Services | General Acute Care Hospital | 11101 N Sherman Rd, Edgerton, WI 53534-9002 | 2006-07-02 |
| 1881640183 | Westfields Hospital, Inc. | General Acute Care Hospital | 535 Hospital Road, New Richmond, WI 54017-1449 | 2006-05-26 |
| 1053362624 | Ripon Medical Center Inc | General Acute Care Hospital | 845 Parkside Street, Ripon, WI 54971-8505 | 2006-05-16 |
| 1255382933 | Cumberland Memorial Hospital | General Acute Care Hospital | 1110 7th Ave, Cumberland, WI 54829-9133 | 2006-05-15 |
| Find all providers with the same taxonomy | ||||
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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.