MOUNDVIEW MEMORIAL HOSPITAL & CLINICS, INC. (NPI# 1962560334) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962560334 |
| Entity Type | Organization |
| Organization Name | MOUNDVIEW MEMORIAL HOSPITAL & CLINICS, INC. |
| Other Organization Name | GUNDERSEN MOUNDVIEW HOSPITAL AND CLINICS, INC. |
| Practice Address |
402 W. Lake St. Friendship WI 53934 |
| Mailing Address |
402 W. Lake St. P.o. Box 40 Friendship WI 53934 |
| Practice Telephone | 6083393331 |
| Mailing Telephone | 6083393331 |
| Enumeration Date | 2006-12-05 |
| Last Update Date | 2020-03-11 |
| Authorized Official Name | FRANK PEREZ-GUERRA (CEO) |
| Authorized Official Telephone | 6083396814 |
| Is Organization Subpart | Y |
| Parent Organization Name | MOUNDVIEW MEMORIAL HOSPITAL & CLINICS, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261Q00000X | Clinic/Center | Ambulatory Health Care Facilities | ||
| Y | 261QR1300X |
Clinic/Center Specialization: Rural Health |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 43061300 | 05 | |
| WI | MEDICARE RAILROAD | CR0660 | 01 |
| Other Name | Type Code |
|---|---|
| Gundersen Moundview Hospital and Clinics, Inc. | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861829194 | Moundview Memorial Hospital & Clinics, Inc. | Clinic/Center | 207 N Pioneer Park Rd, Unit 8, Westfield, WI 53964-9092 | 2013-10-01 |
| 1720147366 | Moundview Memorial Hospital & Clinics, Inc. | Medicare Defined Swing Bed Unit | 402 W Lake St, Friendship, WI 53934-9699 | 2006-12-08 |
| Street Address |
402 W. LAKE ST. |
| City | FRIENDSHIP |
| State | WI |
| Zip Code | 53934 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891901872 | Mary L. Fendt | Physical Therapist | 402 W. Lake St., Friendship, WI 53934 | 2007-05-15 |
| 1134332190 | Mary H. Moll | Physical Therapist | 402 W. Lake St., Friendship, WI 53934 | 2007-05-07 |
| 1235342221 | Kevin B. Beaver | Physical Therapist | 402 W. Lake St., Friendship, WI 53934 | 2007-05-07 |
| 1144433103 | Luann M. Livingston | Occupational Therapist | 402 W. Lake St., Friendship, WI 53934 | 2007-05-07 |
| 1114130192 | Helen Quarles | Occupational Therapist | 402 W. Lake St., Friendship, WI 53934 | 2007-05-07 |
| 1497968481 | Kari A. Gatterman | Physical Therapist | 402 W. Lake St., Friendship, WI 53934 | 2007-05-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396234837 | Gundersen Clinic Ltd | Optometrist | 402a W Lake St, Friendship, WI 53934 | 2018-05-09 |
| 1780972174 | Emily Burzynski Clark | Speech-Language Pathologist | 210 S. Park St, Friendship, WI 53934 | 2011-07-19 |
| 1942492459 | Gene P. Wegner, Sc | Radiology | 302 W Lake Street, Friendship, WI 53934 | 2007-08-17 |
| 1982770723 | Sheryl J. Obernberger | Nurse Practitioner | 402 West Lake St., Friendship, WI 53934 | 2006-11-24 |
| 1992894927 | Robert J Schindlbeck | Dentist | 320 W Lake St, Friendship, WI 53934 | 2006-10-11 |
| 1336173095 | Roche A Cri Clinic Sc | Family Medicine | 302 W. Lake St., Friendship, WI 53934 | 2006-07-10 |
| 1174514699 | Ann M Anderson | Nurse Practitioner | 302 West Lake St, Friendship, WI 53934 | 2005-11-03 |
| 1801881388 | Mark E Hatton | Family Medicine | 402 West Lake Street, Friendship, WI 53934 | 2005-09-12 |
| 1780064956 | Andrew Schmitz | Counselor | 302 W Lake St, Friendship, WI 53934 | 2015-06-03 |
| 1447571062 | Scott Alan Ethun | Social Worker | 302 W Lake St, Friendship, WI 53934 | 2010-06-17 |
| Find all providers in zip 53934 | ||||
| Taxonomy Code | 261QR1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rural Health |
| Definition to come... |
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|---|---|---|---|---|
| 1487962759 | Allcare Medical Pllc | Clinic/Center | 522 Main St, Friendship, TN 38034-1966 | 2010-09-20 |
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| 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 | FRIENDSHIP |
| Zip Code | 53934 |
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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.