DIVINE SAVIOR HEALTHCARE INC (NPI# 1275598948) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1275598948 |
Entity Type | Organization |
Organization Name | DIVINE SAVIOR HEALTHCARE INC |
Other Organization Name | ASPIRUS DIVINE SAVIOR HOSPITAL |
Practice Address |
2817 New Pinery Road Divine Savior Healthcare Inc Portage WI 53901-0387 |
Mailing Address |
Po Box 387 2817 New Pinery Road Divine Savior Healthcare Inc Portage WI 53901-0387 |
Practice Telephone | 6087424131 |
Practice Fax Number | 6087455061 |
Mailing Telephone | 6087424131 |
Mailing Fax Number | 6087426098 |
Enumeration Date | 2006-04-18 |
Last Update Date | 2020-08-26 |
Authorized Official Name | MRS. LORI PECK (VP REVENUE CYCLE) |
Authorized Official Telephone | 7158472988 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 261QE0700X |
Clinic/Center Specialization: End-Stage Renal Disease (ESRD) Treatment |
3729800 | WI | Ambulatory Health Care Facilities |
State | Issuer | Identifier | Type Code |
---|---|---|---|
WI | 42060700 | 05 |
Other Name | Type Code |
---|---|
Aspirus Divine Savior Hospital | Doing Business As Name - Organization |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1376974451 | Divine Savior Healthcare Inc | Non-Pharmacy Dispensing Site | 2817 New Pinery Rd, Portage, WI 53901-9240 | 2013-11-27 |
1316147408 | Divine Savior Healthcare Inc | Medicare Defined Swing Bed Unit | 2817 New Pinery Road, Divine Savior Healthcare Inc, Portage, WI 53901-0387 | 2007-07-18 |
1538124169 | Divine Savior Healthcare Inc | Home Health | 2817 New Pinery Road, Divine Savior Healthcare Inc, Portage, WI 53901-0387 | 2006-04-18 |
Street Address |
2817 NEW PINERY ROAD DIVINE SAVIOR HEALTHCARE INC |
City | PORTAGE |
State | WI |
Zip Code | 53901-0387 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1265428841 | Robert Vincent Castrovinci | Ophthalmology | 2817 New Pinery Road, Portage, WI 53901-0387 | 2005-09-20 |
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 |
1386160125 | Diana L Charlebois | Nurse Practitioner | 2817 New Pinery Road, Portage, WI 53901 | 2017-08-14 |
1851537245 | Aimee Stieve | Physical Therapist | 2817 New Pinery Road, Divine Savior Healthcare, Portage, WI 53901-0387 | 2009-01-06 |
1255508255 | Lori A Schumann | Physical Therapist | 2817 New Pinery Road, Divine Savior Healthcare, Portage, WI 53901-0387 | 2008-05-09 |
1467644195 | James M Swan Jr. | Nurse Practitioner | 2817 New Pinery Road, Divine Savior Healthcare Inc, Portage, WI 53901-0387 | 2007-08-16 |
1316147408 | Divine Savior Healthcare Inc | Medicare Defined Swing Bed Unit | 2817 New Pinery Road, Divine Savior Healthcare Inc, Portage, WI 53901-0387 | 2007-07-18 |
1538177480 | Carol Ada Pierce | Surgery | 2817 New Pinery Road, Divine Savior Healthcare Inc, Portage, WI 53901 | 2006-08-04 |
1922037175 | Daniel R Langan | Nurse Anesthetist, Certified Registered | 2817 New Pinery Road, Divine Savior Healthcare Inc, Portage, WI 53901-0387 | 2006-07-01 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1740710748 | Robert James Corliss | Internal Medicine | St. Vincent Fmc, 140east Cook St., Portage, WI 53901 | 2017-06-13 |
1639328867 | Casey Jo Ambort | Speech-Language Pathologist | 626 East Slifer St, Portage, WI 53901 | 2008-09-11 |
1871767400 | Planned Parenthood of Wi, Inc | Non-Pharmacy Dispensing Site | 132 W. Cook St., Portage, WI 53901 | 2008-04-15 |
1881872158 | Marta Jean Jindra | Physical Therapist | 626 E Slifer Street, Portage, WI 53901 | 2008-02-08 |
1699953976 | Lana Marie Edwards | Speech-Language Pathologist | 626 East Slifer Street, Portage, WI 53901 | 2008-02-08 |
1134314552 | Kristina Hellenbrand | Physical Therapist | 2639 New Pinery Road, Suite 2, Portage, WI 53901 | 2007-09-10 |
1689727810 | Gregory Allan Bindl | Chiropractor | 2121new Pinery Rd, Portage, WI 53901 | 2007-01-19 |
1720149156 | Timothy J Rosin Dds Sc | Dentist | 2570 New Pinery Rd, Portage, WI 53901 | 2006-12-12 |
1710083779 | Currani Seubert Dental Office LLC | Dentist | 260 W Cook St, Portage, WI 53901 | 2006-09-16 |
1225090525 | University of Wisconsin Medical Foundation Inc | Durable Medical Equipment & Medical Supplies | 2977 Cty Hwy Cx, Portage, WI 53901 | 2006-04-04 |
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Taxonomy Code | 261QE0700X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | End-Stage Renal Disease (ESRD) Treatment |
Definition to come... |
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1003921842 | Everest Healthcare Indiana, Inc. | Clinic/Center | 5972 Us Highway 6, Portage, IN 46368-4946 | 2006-08-20 |
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1972008704 | Midwest Legacy Capital LLC | Clinic/Center | W4233 State Rd 54, Black Creek, WI 54106-8633 | 2018-03-26 |
1841792603 | Wisconsin Renal Care Group, L.L.C. | Clinic/Center | 17500 W Capitol Drive, Brookfield, WI 53045 | 2018-03-07 |
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1023527058 | Bio-medical Applications of Wisconsin, Inc. | Clinic/Center | 2831 Okeeffe Ave, Sun Prairie, WI 53590-7057 | 2017-09-21 |
1093234569 | Fresenius Medical Care Milwaukee, LLC | Clinic/Center | 2615 W Silver Spring Dr, Milwaukee, WI 53209-4219 | 2017-09-15 |
1770010928 | Total Renal Care Inc | Clinic/Center | 9127 N 76th St, Milwaukee, WI 53223-1905 | 2017-05-18 |
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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.