DIVINE SAVIOR HEALTHCARE, INC. (NPI# 1861904294) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861904294 |
| Entity Type | Organization |
| Organization Name | DIVINE SAVIOR HEALTHCARE, INC. |
| Other Organization Name | ASPIRUS PARDEEVILLE CLINIC |
| Practice Address |
102 Gillette Street Pardeeville WI 53954 |
| Mailing Address |
2817 New Pinery Road Portage WI 53901-0387 |
| Practice Telephone | 6084292185 |
| Practice Fax Number | 6084293966 |
| Mailing Telephone | 6087450560 |
| Mailing Fax Number | 6087426098 |
| Enumeration Date | 2017-10-25 |
| Last Update Date | 2020-08-26 |
| Authorized Official Name | MRS. LORI PECK (VP REVENUE CYCLE) |
| Authorized Official Telephone | 7158472988 |
| Is Organization Subpart | Y |
| Parent Organization Name | DIVINE SAVIOR HEALTHCARE, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR1300X |
Clinic/Center Specialization: Rural Health |
WI | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 32850500 | 05 |
| Other Name | Type Code |
|---|---|
| ASPIRUS PARDEEVILLE CLINIC | Doing Business As Name - Organization |
| Divine Savior Healthcare - Pardeeville Clinic | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942712344 | Divine Savior Healthcare, Inc. | Clinic/Center | N4390 Crossroads Clinic Road, Oxford, WI 53952 | 2017-10-26 |
| 1831693100 | Divine Savior Healthcare, Inc. | Pharmacy | 2817 New Pinery Road, Portage, WI 53901 | 2018-03-21 |
| 1386154417 | Divine Savior Healthcare, Inc. | Clinic/Center | 2817 New Pinery Road, Portage, WI 53901-0387 | 2017-10-03 |
| 1710133095 | Divine Savior Healthcare, Inc. | Pharmacy | 2817 New Pinery Rd, Portage, WI 53901-9257 | 2008-08-18 |
| 1124083894 | Divine Savior Healthcare, Inc. | General Acute Care Hospital | 2817 New Pinery Rd, Portage, WI 53901-0387 | 2006-04-18 |
| Street Address |
102 GILLETTE STREET |
| City | PARDEEVILLE |
| State | WI |
| Zip Code | 53954 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851819502 | Jacqueline Ann Stencil | Registered Nurse | W3404 Grouse Ave, Pardeevillle, WI 53954 | 2017-09-01 |
| 1912191214 | Pardeeville Area School District | Local Education Agency (LEA) | 120 S Oak St, Pardeeville, WI 53954 | 2007-08-29 |
| 1649390063 | Virginia G Scott | Dentist | 403 W. Chestnut St., Pardeeville, WI 53954 | 2007-03-30 |
| 1649390071 | Kenneth Binkley | Dentist | 403 W. Chestnut Street, Pardeeville, WI 53954 | 2007-03-30 |
| 1629176649 | Pardeeville District Ambulance Service | Ambulance | 501 Gillette St, Pardeeville, WI 53954 | 2006-09-21 |
| 1407976830 | Virginia G Scott Dds | Dentist | 403 W. Chestnut St., Pardeeville, WI 53954 | 2007-03-30 |
| 1902942691 | Stephen D Woxland | Pharmacist | 135 N Main St, Pardeeville, WI 53954 | 2007-01-29 |
| 1578671269 | Woxland Corp | Pharmacy | 135 N Main St, Pardeeville, WI 53954 | 2006-08-25 |
| 1508476953 | Morgan Anne Deakin | Pharmacist | 117 N Main St, Pardeeville, WI 53954-8005 | 2020-07-31 |
| 1043441215 | Kate Hillyer | Pharmacist | 135 N Main St, Pardeeville, WI 53954-8005 | 2009-08-05 |
| Find all providers in zip 53954 | ||||
| Taxonomy Code | 261QR1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rural Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770123218 | Mchs Hospitals, Inc. | Clinic/Center | 3606 Schneider Ave Se, Menomonie, WI 54751-5674 | 2020-01-13 |
| 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 |
| 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 |
| 1851345268 | Amery Regional Medical Center, Inc. | Clinic/Center | 137 First Ave, Luck, WI 54853-9057 | 2006-05-20 |
| Find all providers with the same taxonomy | ||||
| City | PARDEEVILLE |
| Zip Code | 53954 |
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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.