NEW LONDON FAMILY MEDICAL CENTER INC (NPI# 1972928463) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972928463 |
| Entity Type | Organization |
| Organization Name | NEW LONDON FAMILY MEDICAL CENTER INC |
| Other Organization Name | NEW LONDON FAMILY MEDICAL CENTER |
| Practice Address |
1405 Mill St New London WI 54961-2155 |
| Mailing Address |
6501 City West Pkwy Eden Prairie MN 55344-3248 |
| Practice Telephone | 9205312000 |
| Mailing Telephone | 9526532525 |
| Enumeration Date | 2014-02-20 |
| Last Update Date | 2014-02-20 |
| Authorized Official Name | RICHARD BERRY (PHARMACIST) |
| Authorized Official Telephone | 9205312000 |
| Is Organization Subpart | Y |
| Parent Organization Name | NEW LONDON FAMILY MEDICAL CENTER INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332900000X | Non-Pharmacy Dispensing Site | Suppliers |
| Other Name | Type Code |
|---|---|
| New London Family Medical Center | Doing Business As Name - Organization |
| Street Address |
1405 MILL ST |
| City | NEW LONDON |
| State | WI |
| Zip Code | 54961-2155 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598752057 | Hiep T Poppy | Physical Therapy Assistant | 1405 Mill St, New London, WI 54961-2155 | 2005-09-30 |
| 1952918328 | Emily Becher | Physical Therapist | 1405 Mill St, New London, WI 54961-2155 | 2020-09-29 |
| 1699232132 | Alyssa Wentworth | Physician Assistant | 1405 Mill St, New London, WI 54961-2155 | 2019-02-20 |
| 1609390855 | Leah M Lemke | Physician Assistant | 1405 Mill St, New London, WI 54961-2155 | 2017-07-31 |
| 1548783228 | Kelsey Mae Abendroth | Physical Therapist | 1405 Mill St, New London, WI 54961-2155 | 2017-07-25 |
| 1609397280 | Mayka L Rambo | Registered Nurse | 1405 Mill St, New London, WI 54961-2155 | 2017-07-04 |
| 1275087207 | Ryan Wagner | Emergency Medicine | 1405 Mill St, New London, WI 54961-2155 | 2016-08-08 |
| 1679932750 | Kristin M Roesler | Nurse Practitioner | 1405 Mill St, New London, WI 54961-2155 | 2016-02-17 |
| 1740675040 | Bryan Kent Hendrickson | Family Medicine | 1405 Mill St, New London, WI 54961-2155 | 2015-04-02 |
| 1063846491 | Courtney Nicole Shirel | Physical Therapist | 1405 Mill St, New London, WI 54961-2155 | 2013-08-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407406408 | Cheryl Schneider | Technician | L 56 Northgate Estates, New London, WI 54961 | 2019-09-12 |
| 1861634719 | Rebecca L Kramer | Counselor | 315 Burton St, New London, WI 54961 | 2009-03-24 |
| 1598913501 | Marsha Ann Nytes | Licensed Practical Nurse | E8222 Weyawega Rd, New London, WI 54961 | 2008-09-03 |
| 1659585172 | Amanda L. Beck | Physical Therapy Assistant | 400 E. 4th Street, Manawa, WI 54961 | 2007-05-10 |
| 1366599433 | Griebenow Eyecare, S.c. | Optometrist | 105 Northridge Drive, New London, WI 54961 | 2007-01-04 |
| 1740822055 | Lauren Mae Flunker | Social Worker | E7475 Rawhide Rd, New London, WI 54961 | 2019-10-09 |
| 1063641249 | Forefront Dermatology, S.c. | Dermatology | 1620 N Shawano St, Suite C, New London, WI 54961 | 2009-07-08 |
| 1093982530 | Ascension Medical Group-fox Valley Wisconsin, Inc | Clinic/Center | 1420 Algoma St, New London, WI 54961 | 2008-05-14 |
| 1821263849 | Mark Alan Tegtmeier | Counselor | E7475 Rawhide Rd, New London, WI 54961 | 2008-04-30 |
| 1639282544 | Ascension Medical Group-fox Valley Wisconsin, Inc | Durable Medical Equipment & Medical Supplies | 1420 Algoma St, New London, WI 54961 | 2006-08-16 |
| Find all providers in zip 54961 | ||||
| Taxonomy Code | 332900000X |
| Grouping | Suppliers |
| Classification | Non-Pharmacy Dispensing Site |
| A site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.) |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477188100 | Froedtert & The Medical College of Wisconsin Community Physicians Inc | Non-Pharmacy Dispensing Site | 635 S 28th St, Milwaukee, WI 53215-1201 | 2020-03-03 |
| 1841845385 | Planned Parenthood of Wisconsin | Non-Pharmacy Dispensing Site | 223 South Main St., Blair, WI 54616 | 2019-08-01 |
| 1982258737 | Planned Parenthood of Wisconsin | Non-Pharmacy Dispensing Site | 919 Hoeschler Dr Ste 100, Sparta, WI 54656-2202 | 2019-07-30 |
| 1780142992 | Froedtert & The Medical College of Wisconsin Community Physicians | Non-Pharmacy Dispensing Site | 11040 N Range Line Rd, Mequon, WI 53092-4930 | 2019-03-06 |
| 1992284087 | Froedtert & The Medical College of Wisconsin Community Physicians | Non-Pharmacy Dispensing Site | 4859 South 60th Street, Greenfield, WI 53220 | 2018-08-09 |
| 1801373378 | Froedtert & The Medical College of Wisconsin Community Physicians | Non-Pharmacy Dispensing Site | 1721 W Canal St, Milwaukee, WI 53233 | 2018-07-26 |
| 1205355500 | Froedtert Health | Non-Pharmacy Dispensing Site | 4850 S 60th St, Greenfield, WI 53220-4616 | 2017-09-18 |
| 1790071637 | St Mary's Hospital Medical Center | Non-Pharmacy Dispensing Site | 2840 Okeeffe Ave, Sun Prairie, WI 53590-7077 | 2011-06-20 |
| 1629390729 | Jt Medical Services, Inc. | Non-Pharmacy Dispensing Site | 12855 West Lisbon Road, 2nd Floor, Brookfield, WI 53005 | 2010-02-17 |
| 1013243294 | Barron County Office On Aging | Non-Pharmacy Dispensing Site | 335 E. Monroe Avenue, Room 112, Barron, WI 54812-1478 | 2009-10-23 |
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| City | NEW LONDON |
| Zip Code | 54961 |
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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.