THEDACARE MEDICAL CENTER - SHAWANO, INC. (NPI# 1801447925) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801447925 |
| Entity Type | Organization |
| Organization Name | THEDACARE MEDICAL CENTER - SHAWANO, INC. |
| Practice Address |
370 S Main St Clintonville WI 54929-1632 |
| Mailing Address |
122 E College Ave Appleton WI 54911-5794 |
| Practice Telephone | 7158235161 |
| Practice Fax Number | 7158231386 |
| Mailing Telephone | 9209963264 |
| Mailing Fax Number | 9208305910 |
| Enumeration Date | 2019-09-20 |
| Last Update Date | 2019-09-20 |
| Authorized Official Name | MARK STEVEN THOMPSON (CFO) |
| Authorized Official Telephone | 9208305885 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR1300X |
Clinic/Center Specialization: Rural Health |
Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548260839 | Thedacare Medical Center - Shawano, Inc. | General Acute Care Hospital | 100 County Road B, Shawano, WI 54166-7072 | 2005-07-28 |
| 1649821760 | Thedacare Medical Center - Shawano, Inc. | Clinic/Center | 100 County Road B, Shawano, WI 54166-7072 | 2019-09-20 |
| 1720493125 | Thedacare Medical Center - Shawano, Inc. | Clinical Medical Laboratory | 100 County Road B, Shawano, WI 54166-7072 | 2014-06-24 |
| 1710206636 | Thedacare Medical Center - Shawano, Inc. | Non-Pharmacy Dispensing Site | 6501 City West Pkwy, Eden Prairie, MN 55344-3248 | 2010-05-18 |
| 1265618979 | Thedacare Medical Center - Shawano, Inc. | Medicare Defined Swing Bed Unit | 100 County Road B, Shawano, WI 54166-7072 | 2008-01-11 |
| Street Address |
370 S MAIN ST |
| City | CLINTONVILLE |
| State | WI |
| Zip Code | 54929-1632 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174559132 | Cynthia Egan | Family Medicine | 370 S Main St, Clintonville, WI 54929-1632 | 2006-06-23 |
| 1043721970 | Lauren E Dailey | Physician Assistant | 370 S Main St, Clintonville, WI 54929-1632 | 2017-10-18 |
| 1144675745 | Thedacare Medical Center - New London, Inc. | General Acute Care Hospital | 370 S Main St, Clintonville, WI 54929-1632 | 2016-05-02 |
| 1841603438 | Sara L Messner | Physician Assistant | 370 S Main St, Clintonville, WI 54929-1632 | 2014-06-11 |
| 1235563420 | Melanie Lynne Wilke | Physical Therapist | 370 S Main St, Clintonville, WI 54929-1632 | 2013-08-25 |
| 1548516941 | Lesley A Fuerst | Nurse Practitioner | 370 S Main St, Clintonville, WI 54929-1632 | 2012-08-03 |
| 1033379888 | Cindy Griswold | Nurse Practitioner | 370 S Main St, Clintonville, WI 54929-1632 | 2008-06-16 |
| 1285893370 | Chad A Landwehr | Physician Assistant | 370 S Main St, Clintonville, WI 54929-1632 | 2008-06-04 |
| 1538191630 | Rita Braund | Physician Assistant | 370 S Main St, Clintonville, WI 54929-1632 | 2006-07-07 |
| 1851328033 | Leslie Gray | Family Medicine | 370 S Main St, Clintonville, WI 54929-1632 | 2006-06-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003045402 | Griebenow Eyecare, S.c. | Optometrist | 45 10th St., Clintonville, WI 54929 | 2009-07-07 |
| 1093835266 | William Henry Krueger | Chiropractor | E9180 Golf Club Road, Clintonville, WI 54929 | 2007-03-30 |
| 1255445680 | Leah K. Smejkal | Physical Therapist | 114 E. Greentree Road, Clintonville, WI 54929 | 2006-08-19 |
| 1962422303 | Clintonville Area Ambulance Service | Ambulance | 16 N. Main, Clintonville, WI 54929 | 2006-07-20 |
| 1649225970 | Jill I. Timm | Physical Therapist | 114 E Greentree Road, Clintonville, WI 54929 | 2006-05-24 |
| 1104242999 | Cloverleaf Healthcare, Inc. | Skilled Nursing Facility | 1625 E Main St, Clintonville, WI 54929 | 2014-03-17 |
| 1124286406 | Ascension Medical Group-fox Valley Wisconsin, Inc | Clinic/Center | 61 Anne St, Clintonville, WI 54929 | 2008-05-23 |
| 1174734289 | Samuel John Buckett | Chiropractor | E9180 Golf Club Road, Clintonville, WI 54929 | 2007-05-24 |
| 1811057961 | Karen Agnete Johnson | Dentist | 112 S Main Street, Clintonville, WI 54929 | 2006-12-11 |
| 1164509154 | Erickson Home Medical Equipment LLC | Durable Medical Equipment & Medical Supplies | 8 S Main St, Clintonville, WI 54929 | 2006-11-01 |
| Find all providers in zip 54929 | ||||
| Taxonomy Code | 261QR1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rural Health |
| Definition to come... |
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|---|---|---|---|---|
| 1730171331 | Grove City Medical Center | Clinic/Center | 208 Butler St, Clintonville, PA 16372 | 2005-08-19 |
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|---|---|---|---|---|
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| 1639733173 | Lafayette County | Clinic/Center | 107 Center Street, Argyle, WI 53504 | 2019-04-30 |
| 1942712344 | Divine Savior Healthcare, Inc. | Clinic/Center | N4390 Crossroads Clinic Road, Oxford, WI 53952 | 2017-10-26 |
| 1861904294 | Divine Savior Healthcare, Inc. | Clinic/Center | 102 Gillette Street, Pardeeville, WI 53954 | 2017-10-25 |
| 1366878449 | Amery Regional Medical Center, Inc | Clinic/Center | 357 Third Ave, Clear Lake, WI 54005-0177 | 2013-09-19 |
| 1851652374 | St. Croix Regional Medical Center | Clinic/Center | 26425 Lakeland Avenue South, Webster, WI 54893-8341 | 2012-05-31 |
| 1811256126 | St. Croix Regional Medical Center | Clinic/Center | 205 West Oak Street, Frederic, WI 54837 | 2012-05-07 |
| 1508198961 | Door County Memorial Hospital | Clinic/Center | 3711 Highway 42, Fish Creek, WI 54212 | 2010-02-09 |
| 1174627483 | Door County Memorial Hospital | Clinic/Center | 910 Main Rd, Washington Island, WI 54246 | 2006-09-08 |
| 1881607463 | St. Joseph's Health Services, Inc | Clinic/Center | 301 Railroad Rd, Wonewoc, WI 53968-9425 | 2006-08-14 |
| Find all providers with the same taxonomy | ||||
| City | CLINTONVILLE |
| Zip Code | 54929 |
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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.