FOND DU LAC COUNTY (NPI# 1235252024) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235252024 |
| Entity Type | Organization |
| Organization Name | FOND DU LAC COUNTY |
| Other Organization Name | FOND DU LAC COUNTY DCP ACUTE UNIT |
| Practice Address |
459 E 1st St Fond Du Lac WI 54935-4505 |
| Practice Telephone | 9209293500 |
| Mailing Telephone | 9209293500 |
| Enumeration Date | 2007-04-09 |
| Last Update Date | 2019-11-27 |
| Authorized Official Name | DR. J R MUSUNURU (CLINICAL DIRECTOR) |
| Authorized Official Telephone | 9209293500 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 251S00000X | Community/Behavioral Health | Agencies | ||
| Y | 283Q00000X | Psychiatric Hospital | Hospitals |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 10062400 | 05 |
| Other Name | Type Code |
|---|---|
| Fond du Lac County DCP Acute Unit | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003951468 | Fond Du Lac County | Skilled Nursing Facility | 459 East First Street, Fond Du Lac, WI 54935-4505 | 2007-02-21 |
| 1679545917 | Fond Du Lac County | Home Health | 160 S Macy St, Fond Du Lac, WI 54935-4241 | 2006-02-02 |
| 1659358323 | Fond Du Lac County | Skilled Nursing Facility | 459 E 1st St, Fond Du Lac, WI 54935-4505 | 2005-12-23 |
| 1053458935 | Fond Du Lac County | Community/Behavioral Health | 459 E 1st St, Fond Du Lac, WI 54935-4505 | 2007-01-31 |
| 1285606178 | Fond Du Lac County | Public Health or Welfare | 160 S Macy St, Fond Du Lac, WI 54935-4241 | 2006-02-03 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | FOND DU LAC COUNTY HOUSING AUTHORITY | 15 N Marr St, Fond Du Lac, WI 54935-3463 |
| System for Award Management (SAM) Entities | FOND DU LAC COUNTY WI | 160 S Macy St, Fond Du Lac, WI 54935-4241 |
| Street Address |
459 E 1ST ST |
| City | FOND DU LAC |
| State | WI |
| Zip Code | 54935-4505 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659358323 | Fond Du Lac County | Skilled Nursing Facility | 459 E 1st St, Fond Du Lac, WI 54935-4505 | 2005-12-23 |
| 1851999114 | Megan Moore | Physical Therapist | 459 E 1st St, Fond Du Lac, WI 54935-4505 | 2020-10-09 |
| 1215550397 | Kayla Pieper | Case Manager/Care Coordinator | 459 E 1st St, Fond Du Lac, WI 54935-4505 | 2020-05-22 |
| 1942832811 | Matthew Olig | Occupational Therapist | 459 E 1st St, Fond Du Lac, WI 54935-4505 | 2020-02-10 |
| 1609408681 | Emma K Felckowski | Occupational Therapy Assistant | 459 E 1st St, Fond Du Lac, WI 54935-4505 | 2020-02-07 |
| 1811533607 | Brittany Stark | Counselor | 459 E 1st St, Fond Du Lac, WI 54935-4505 | 2019-11-27 |
| 1629613591 | Angela Brahm | Case Manager/Care Coordinator | 459 E 1st St, Fond Du Lac, WI 54935-4505 | 2019-11-14 |
| 1336790500 | Lynn Propson | Social Worker | 459 E 1st St, Fond Du Lac, WI 54935-4505 | 2019-09-27 |
| 1376199208 | Jaclyn Rose Hanson | Physical Therapy Assistant | 459 E 1st St, Fond Du Lac, WI 54935-4505 | 2019-08-15 |
| 1972165017 | Joseph Babiak | Counselor | 459 E 1st St, Fond Du Lac, WI 54935-4505 | 2019-06-28 |
| 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 | 283Q00000X |
| Grouping | Hospitals |
| Classification | Psychiatric Hospital |
| An organization including a physical plant and personnel that provides multidisciplinary diagnostic and treatment mental health services to patients requiring the safety, security, and shelter of the inpatient or partial hospitalization settings. |
| Notes: Source: Expanded from Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003413816 | Sbh-madison LLC | Psychiatric Hospital | 3169 Deming Way, Middleton, WI 53562-1435 | 2020-10-05 |
| 1164736021 | Andrew Jay Kessler | Psychiatric Hospital | 1west Lincoln Avenue, Waupun, WI 53595 | 2010-08-03 |
| 1801908975 | County of Brown | Psychiatric Hospital | 3150 Gershwin Drive, Green Bay, WI 54311-5859 | 2006-08-31 |
| 1083728612 | County of Milwaukee | Psychiatric Hospital | 9455 W Watertown Plank Rd, Milwaukee, WI 53226-3559 | 2006-08-19 |
| 1205292869 | Veteran Health Administration | Psychiatric Hospital | 2500 Overlook Ter, Madison, WI 53705-2254 | 2016-01-12 |
| 1013212810 | Milwaukee County Behavioral Health | Psychiatric Hospital | 9201 W Watertown Plank Rd, Milwaukee, WI 53226-3558 | 2011-01-26 |
| 1104139021 | Wfhc - All Saints | Psychiatric Hospital | 1320 Wisconsin Ave, Racine, WI 53403-1978 | 2010-07-20 |
| 1053588293 | Joanne Zimmerman | Psychiatric Hospital | 9455 W Watertown Plank Rd, Milwaukee, WI 53226-3559 | 2008-05-15 |
| 1407988892 | County of Waukesha Department of Finance | Psychiatric Hospital | 1501 Airport Rd, Waukesha, WI 53188-3632 | 2007-03-12 |
| 1164516506 | State of Wisconsin | Psychiatric Hospital | 1300 South Drive, Winnebago, WI 54985-0009 | 2006-10-02 |
| Find all providers with the same taxonomy | ||||
| City | FOND DU LAC |
| Zip Code | 54935 |
Please comment or provide details below to improve the information on FOND DU LAC COUNTY.
| 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.