AGNESIAN HEALTHCARE (NPI# 1861438913) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861438913 |
| Entity Type | Organization |
| Organization Name | AGNESIAN HEALTHCARE |
| Other Organization Name | FOND DU LAC REGIONAL CLINIC |
| Practice Address |
480 E Division St Fond Du Lac WI 54935-3734 |
| Mailing Address |
420 E Division St Fond Du Lac WI 54935-4560 |
| Practice Telephone | 9209264100 |
| Mailing Telephone | 9209268340 |
| Enumeration Date | 2006-06-20 |
| Last Update Date | 2007-11-26 |
| Authorized Official Name | STEVEN N LITTLE (SVP & CFO) |
| Authorized Official Telephone | 9209265402 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers |
| Other Name | Type Code |
|---|---|
| FOND DU LAC REGIONAL CLINIC | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013157981 | Agnesian Healthcare | Community/Behavioral Health | 1567 E Sumner St, Suite 201, Hartford, WI 53027-2608 | 2009-03-04 |
| 1760419733 | Agnesian Healthcare | Durable Medical Equipment & Medical Supplies | 14 Beaver Dam St, Waupun, WI 53963-1869 | 2006-06-27 |
| 1700817657 | Agnesian Healthcare | Clinic/Center | 200 Front St, Suite 3d, Beaver Dam, WI 53916-1667 | 2006-07-06 |
| 1770529828 | Agnesian Healthcare | Durable Medical Equipment & Medical Supplies | 137 Cambria St, Randolph, WI 53956 | 2006-06-20 |
| 1114963261 | Agnesian Healthcare | Durable Medical Equipment & Medical Supplies | 100 Evergreen Rd, Mount Calvary, WI 53057-9726 | 2006-06-20 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | AGNESIAN HEALTHCARE | 933 Newbury St, Ripon, WI 54971-1730 |
| Street Address |
480 E DIVISION ST |
| City | FOND DU LAC |
| State | WI |
| Zip Code | 54935-3734 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164403226 | Michael W Jones | Internal Medicine | 480 E Division St, Fond Du Lac, WI 54935-3734 | 2005-11-07 |
| 1144827734 | Kelly Marie Hagner | Nurse Practitioner | 480 E Division St, Fond Du Lac, WI 54935-3734 | 2020-10-06 |
| 1952735516 | Lisa Mae Michels | Nurse Practitioner | 480 E Division St, Fond Du Lac, WI 54935-3734 | 2013-08-30 |
| 1376899393 | Sameer Tolay | Internal Medicine | 480 E Division St, Fond Du Lac, WI 54935-3734 | 2012-07-27 |
| 1902174089 | Rebecca L Lentscher | Nurse Practitioner | 480 E Division St, Fond Du Lac, WI 54935-3734 | 2011-12-05 |
| 1700101250 | Adam Lawrence Liss | Radiology | 480 E Division St, Fond Du Lac, WI 54935-3734 | 2010-03-27 |
| 1174756696 | Filip T Troicki | Radiology | 480 E Division St, Fond Du Lac, WI 54935-3734 | 2009-09-01 |
| 1124245253 | Lori J Wendt | Nurse Practitioner | 480 E Division St, Fond Du Lac, WI 54935-3734 | 2007-04-19 |
| 1114938156 | Hong Chu Wang | Radiology | 480 E Division St, Fond Du Lac, WI 54935-3734 | 2006-08-11 |
| 1144247941 | Central Wisconsin Radiation Oncology, S.c. | Radiology | 480 E Division St, Fond Du Lac, WI 54935-3734 | 2006-07-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609482249 | Keziah Sherri Love | Counselor | W390 Wi-23, Fond Du Lac, WI 54935 | 2020-09-18 |
| 1891341988 | Cynthia Louise Singleton | Nurse Practitioner | 16 E 13th St., Fond Du Lac, WI 54935 | 2019-08-14 |
| 1083183297 | Elena Alexandra Giese | Nurse Practitioner | 430 E. Division St, Fond Du Lac, WI 54935 | 2018-11-16 |
| 1669963740 | Elizabeth Anne Machi | Student in an Organized Health Care Education/Training Program | 885 Western Ave Ste 300, Fond Du Lac, WI 54935 | 2018-05-23 |
| 1184150021 | Jordan Moehn | Specialist/Technologist | 633 Prairie Pkwy, Fond Du Lac, WI 54935 | 2017-05-11 |
| 1467856336 | Chuentao Ho | Specialist/Technologist | 45 South National Ave., Fond Du Lac, WI 54935 | 2014-10-21 |
| 1437587961 | Paula Seeley | Nurse Practitioner | 63 West Pioneer Rd, Fond Du Lac, WI 54935 | 2013-10-18 |
| 1144516030 | Bonnie Kay Mallon | Registered Nurse | 118 E 9th St, Fond Du Lac, WI 54935 | 2011-06-20 |
| 1770885600 | Holly Shepard | Counselor | 23 W Scott St., Fond Du Lac, WI 54935 | 2010-11-29 |
| 1437479110 | Ruth Marie Bohn | Occupational Therapy Assistant | 244 North Macy Street, Fond Du Lac, WI 54935 | 2010-06-04 |
| Find all providers in zip 54935 | ||||
| Taxonomy Code | 332B00000X |
| Grouping | Suppliers |
| Classification | Durable Medical Equipment & Medical Supplies |
| A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient’s use in the home and that are usable for an extended period of time. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518377720 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 1060 E Johnson St, Fond Du Lac, WI 54935-8900 | 2014-04-28 |
| 1548372261 | Fond Du Lac Prescription Center, Ltd | Durable Medical Equipment & Medical Supplies | 52 Sheboygan St, Fond Du Lac, WI 54935-4220 | 2006-08-31 |
| 1649285537 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 192 N Main St, Fond Du Lac, WI 54935-3462 | 2006-07-29 |
| 1710904867 | Wal-mart Stores East Lp | Durable Medical Equipment & Medical Supplies | 377 N Rolling Meadows Dr, Fond Du Lac, WI 54937-9726 | 2006-07-16 |
| 1487990651 | Agnesian Healthcare Inc | Durable Medical Equipment & Medical Supplies | 21 S Marr St, Fond Du Lac, WI 54935-4334 | 2012-12-17 |
| 1972749992 | Agnesian Healthcare Inc | Durable Medical Equipment & Medical Supplies | 912 S Hickory St, Fond Du Lac, WI 54935-5530 | 2008-12-22 |
| 1235359118 | Agnesian Healthcare Inc | Durable Medical Equipment & Medical Supplies | 1088 S Main St, Fond Du Lac, WI 54935 | 2007-04-26 |
| 1306993589 | Aurora Medical Group, Inc. | Durable Medical Equipment & Medical Supplies | 210 Wisconsin American Dr, Fond Du Lac, WI 54935-2999 | 2007-01-03 |
| 1689610735 | Agnesian Healthcare Inc | Durable Medical Equipment & Medical Supplies | 145 N Main St, Fond Du Lac, WI 54935-3423 | 2006-06-20 |
| 1083676217 | Agnesian Healthcare Inc | Durable Medical Equipment & Medical Supplies | 421 Camelot Dr, Fond Du Lac, WI 54935-8335 | 2006-04-04 |
| Find all providers in FOND DU LAC | ||||
| City | FOND DU LAC |
| Zip Code | 54935 |
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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.