ST MARY'S HOSPITAL MEDICAL CENTER OF GREEN BAY INC.-HOSPITAL SISTERS (NPI# 1043828387) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043828387 |
| Entity Type | Organization |
| Organization Name | ST MARY'S HOSPITAL MEDICAL CENTER OF GREEN BAY INC.-HOSPITAL SISTERS |
| Practice Address |
1726 Shawano Ave Green Bay WI 54303-3282 |
| Practice Telephone | 9204984200 |
| Mailing Telephone | 9204984200 |
| Enumeration Date | 2020-07-22 |
| Last Update Date | 2020-07-22 |
| Authorized Official Name | BRIAN CHARLIER (CEO/PRESIDENT) |
| Authorized Official Telephone | 9206761148 |
| Is Organization Subpart | Y |
| Parent Organization Name | ST MARY'S HOSPITAL MEDICAL CENTER OF GREEN BAY INC.-HOSPITAL SIS |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 291U00000X | Clinical Medical Laboratory | Laboratories |
| Other Name | Type Code |
|---|---|
| St. Mary's Hospital Outpatient Lab | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649246877 | St Mary's Hospital Medical Center of Green Bay Inc.-hospital Sisters | General Acute Care Hospital | 1726 Shawano Ave, Green Bay, WI 54303-3216 | 2006-02-27 |
| Street Address |
1726 SHAWANO AVE |
| City | GREEN BAY |
| State | WI |
| Zip Code | 54303-3282 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356324990 | Thomas M. Farley | Anesthesiology | 1726 Shawano Ave, Green Bay, WI 54303-3216 | 2005-11-29 |
| 1265048805 | Hillary Ann Bashaw | Nurse Practitioner | 1726 Shawano Ave, Green Bay, WI 54303-3216 | 2020-09-18 |
| 1750930079 | Jenna Mae Spude | Nurse Practitioner | 1726 Shawano Ave, Green Bay, WI 54303-3216 | 2019-09-09 |
| 1215423504 | Matthew James Dolan | Physician Assistant | 1726 Shawano Ave, Green Bay, WI 54303 | 2018-07-10 |
| 1013430073 | Whitney Jo Brusich | Physician Assistant | 1726 Shawano Ave, Green Bay, WI 54303-3216 | 2017-07-21 |
| 1720510043 | Christina R Mestelle | Physical Therapist | 1726 Shawano Ave, Green Bay, WI 54303 | 2017-03-28 |
| 1407231178 | Ahmed Farouk Mohammed | Internal Medicine | 1726 Shawano Ave, Green Bay, WI 54303-3216 | 2015-07-23 |
| 1184004236 | St. Vincent Hospital-hospital Sisters-third Order of St. Francis | Internal Medicine | 1726 Shawano Ave, Green Bay, WI 54303-3216 | 2015-06-04 |
| 1629468343 | Lynn Wilson | Nurse Practitioner | 1726 Shawano Ave, Green Bay, WI 54303-3216 | 2015-02-02 |
| 1063821502 | Kayla Rene' Guns | Registered Nurse | 1726 Shawano Ave, Green Bay, WI 54303-3216 | 2014-08-08 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952921033 | Ashley Marie Vandermoss | Social Worker | 1601 W Mason Street, Green Bay, WI 54303 | 2020-04-20 |
| 1598307423 | Jean Marie Castaneda | Case Manager/Care Coordinator | 2517 N. Court, Green Bay, WI 54303 | 2019-10-11 |
| 1215579552 | Integrated Treatment Centers, LLC | Clinic/Center | 2311 W Mason Street, Green Bay, WI 54303 | 2019-10-08 |
| 1003460551 | Affordable Dentures & Implants - Green Bay, S.c. | Dentist | 1800-c W. Mason Street, Green Bay, WI 54303 | 2019-08-01 |
| 1164940375 | Kaeley Rae Blaney | Student in an Organized Health Care Education/Training Program | 2088 Memorial Drive #208, Green Bay, WI 54303 | 2017-09-07 |
| 1518498047 | Treatment Providers LLC | Clinic/Center | 2731 N Packerland Dr Ste A, Green Bay, WI 54303 | 2017-03-26 |
| 1851840565 | Back To Balance Chiropractic, LLC | Chiropractor | 110 Packerland Drive, Suite B, Green Bay, WI 54303 | 2016-09-23 |
| 1710361001 | Matthew Lemay | Acupuncturist | 727 E Walnut, Suite B2, Green Bay, WI 54303 | 2015-07-16 |
| 1144600149 | Carrie Jean Banaszak | Counselor | 1039 Mason Street, Green Bay, WI 54303 | 2015-06-04 |
| 1174921993 | Kensey Meyer | Occupational Therapy Assistant | 1555 Dousman Road, Seymour, WI 54303 | 2014-12-10 |
| Find all providers in zip 54303 | ||||
| Taxonomy Code | 291U00000X |
| Grouping | Laboratories |
| Classification | Clinical Medical Laboratory |
| (1) A clinical laboratory is a facility for the biological, microbiological, serological, chemical, immunohematological, hematological, biophysical, cytological, pathological, or other examination of materials derived from the human body for the purpose of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, human beings. These examinations also include procedures to determine, measure, or otherwise describe the presence or absence of various substances or organisms in the body. Facilities only collecting or preparing specimens (or both) or only serving as a mailing service and not performing testing are not considered clinical laboratories. (2) Any facility that examines materials from the human body for purposes of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, or the assessment of, the health of human beings. Typical divisions of a clinical laboratory include hematology, cytology, bacteriology, histology, biochemistry, medical toxicology, and serology. |
| Notes: Source: (1) Code of Federal Regulations #42, Public Health, Section 493.2. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 186. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952716987 | Cherry Optical Inc. | Clinical Medical Laboratory | 1640b Fire Lane Dr, Green Bay, WI 54311-6245 | 2014-06-28 |
| 1811203367 | Employment Health Services, LLC | Clinical Medical Laboratory | 721 Cardinal Ln Ste 100, Green Bay, WI 54313-3216 | 2010-08-23 |
| 1124440839 | Bellin Health Independent Labs | Clinical Medical Laboratory | 744 S Webster Ave, Green Bay, WI 54301-3505 | 2014-01-15 |
| 1972829554 | St. Vincent Hospital-hospital Sisters-third Order of St Francis | Clinical Medical Laboratory | 835 S Van Buren St, Green Bay, WI 54301-3526 | 2010-04-08 |
| 1891937256 | Bellin Memorial Hospital, Inc. | Clinical Medical Laboratory | 744 S Webster Ave, Green Bay, WI 54301-3505 | 2009-04-01 |
| 1740470616 | St Vincent Hospital of The Hospital Sisters-third Order of St Francis | Clinical Medical Laboratory | 835 S Van Buren St, Green Bay, WI 54301-3526 | 2007-07-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699382481 | Elicia A Liebe | Clinical Medical Laboratory | 4733 W Montana St, Milwaukee, WI 53219-3375 | 2020-09-26 |
| 1881203826 | Quest Diagnostics LLC Il | Clinical Medical Laboratory | 4852 S 6th St, Milwaukee, WI 53221-2462 | 2020-07-27 |
| 1043854144 | Stemina Biomarker Discovery, Inc. | Clinical Medical Laboratory | 504 S Rosa Rd Ste 150, Madison, WI 53719-1218 | 2019-10-31 |
| 1881238269 | Derek Raymond Schindler | Clinical Medical Laboratory | 680 Baker Rd, Hudson, WI 54016-7901 | 2019-10-29 |
| 1487296307 | Exact Sciences Laboratories, LLC | Clinical Medical Laboratory | 650 Forward Drive, Madison, WI 53711 | 2019-10-11 |
| 1003391269 | Precise Testing LLC | Clinical Medical Laboratory | 6815 W Capitol Dr Ste 105, Milwaukee, WI 53216-2056 | 2018-10-03 |
| 1992286074 | Rprd Diagnostics LLC | Clinical Medical Laboratory | 1225 Discovery Parkway, Suite 260, Milwaukee, WI 53226 | 2018-08-27 |
| 1164938916 | Tai Diagnostics, Inc. | Clinical Medical Laboratory | 10101 W Innovation Dr Ste 600, Wauwatosa, WI 53226-4824 | 2017-12-15 |
| 1831619535 | Laboratory Corporation of America | Clinical Medical Laboratory | 1111 Delafield St Ste 301, Waukesha, WI 53188-3407 | 2017-06-23 |
| 1558896498 | Noah Associates Incorporated | Clinical Medical Laboratory | 10501 W Greenfield Ave, West Allis, WI 53214-2421 | 2017-04-28 |
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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.