VERNON MEMORIAL HEALTHCARE, INC. (NPI# 1376549824) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376549824 |
| Entity Type | Organization |
| Organization Name | VERNON MEMORIAL HEALTHCARE, INC. |
| Other Organization Name | KICKAPOO VALLEY MEDICAL CLINIC - VMH |
| Practice Address |
102 Sunset Ave Soldiers Grove WI 54655-1400 |
| Mailing Address |
507 S Main St Viroqua WI 54665-2059 |
| Practice Telephone | 6086245203 |
| Practice Fax Number | 6086245572 |
| Mailing Telephone | 6086245203 |
| Mailing Fax Number | 6086385039 |
| Enumeration Date | 2005-06-21 |
| Last Update Date | 2020-01-07 |
| Authorized Official Name | DAVID HARTBERG (CEO) |
| Authorized Official Telephone | 6086374796 |
| Is Organization Subpart | Y |
| Parent Organization Name | VERNON MEMORIAL HEALTHCARE, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR1300X |
Clinic/Center Specialization: Rural Health |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Kickapoo Valley Medical Clinic - VMH | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295708204 | Vernon Memorial Healthcare, Inc. | Home Health | 705 Arena Dr, Viroqua, WI 54665-2059 | 2006-02-09 |
| 1619969490 | Vernon Memorial Healthcare, Inc. | Pharmacist | 104 Sunset Ave, Soldiers Grove, WI 54655-7523 | 2005-08-18 |
| 1215933767 | Vernon Memorial Healthcare, Inc. | Clinic/Center | 100 Melby St, Westby, WI 54667-1012 | 2005-06-21 |
| 1750387221 | Vernon Memorial Healthcare, Inc. | Clinic/Center | 206 North Mill Street, La Farge, WI 54639-6601 | 2005-06-21 |
| 1164752648 | Vernon Memorial Healthcare, Inc. | General Acute Care Hospital | 507 S Main St, Viroqua, WI 54665-2059 | 2010-01-06 |
| 1467425488 | Vernon Memorial Healthcare, Inc. | Hospice Care, Community Based | 705 Arena Dr, Viroqua, WI 54665-2059 | 2006-02-09 |
| 1992701031 | Vernon Memorial Healthcare, Inc. | General Acute Care Hospital | 507 S Main St, Viroqua, WI 54665-2059 | 2005-06-23 |
| 1497750921 | Vernon Memorial Healthcare, Inc. | General Acute Care Hospital | 507 S Main St, Viroqua, WI 54665-2059 | 2005-06-21 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | VERNON MEMORIAL HEALTHCARE, INC. | 507 S Main St, Viroqua, WI 54665-2059 |
| Street Address |
102 SUNSET AVE |
| City | SOLDIERS GROVE |
| State | WI |
| Zip Code | 54655-1400 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194143487 | Joel Charles | Family Medicine | 102 Sunset Ave, Soldiers Grove, WI 54655 | 2014-04-03 |
| 1982648697 | Lisa J Varnes-epstein | Physician Assistant | 102 Sunset Ave, Soldiers Grove, WI 54655-1400 | 2006-06-15 |
| 1740224492 | Tammy S Pedretti | Physician Assistant | 102 Sunset Ave, Soldiers Grove, WI 54655-1400 | 2006-06-15 |
| 1801838784 | Timothy J Devitt | Family Medicine | 102 Sunset Ave, Soldiers Grove, WI 54655-1400 | 2006-06-12 |
| 1215974670 | Patricia A Swasko | Nurse Practitioner | 102 Sunset Ave, Soldiers Grove, WI 54655-1047 | 2006-06-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275164709 | Katrina M. Johnson, LLC | Clinic/Center | 106 Passive Sun Drive, Soldiers Grove, WI 54655 | 2020-02-03 |
| 1942509948 | Amy Lynn Byl | Registered Nurse | 46727 Hollenbeck Road, Soldiers Grove, WI 54655 | 2011-03-17 |
| 1124171699 | Donald Stoebner | Pharmacist | 100 Passive Sun Dr, Soldiers Grove, WI 54655 | 2007-01-19 |
| 1144350067 | North Crawford Rescue Squad, Inc. | Ambulance | 102 Legion Dr., Soldiers Grove, WI 54655-0037 | 2007-03-07 |
| 1134208218 | Sannes Skogdalen Nursing Facility LLC | Skilled Nursing Facility | 101 Sunshine Blvd, Soldiers Grove, WI 54655-0177 | 2006-11-02 |
| 1164999678 | Sara L Mand | Registered Nurse | 14798 Bear Creek Dr, Soldiers Grove, WI 54655-6524 | 2018-11-01 |
| 1033620596 | Nsh Soldiers Grove LLC | Skilled Nursing Facility | 101 Sunshine Blvd, Soldiers Grove, WI 54655-7106 | 2017-10-23 |
| 1598145815 | Stacey Drew-regan | Physical Therapist | 101 Sunshine Blvd, Soldiers Grove, WI 54655-7106 | 2015-06-02 |
| 1649547472 | Teri J Thomas | Occupational Therapy Assistant | 101 Sunshine Blvd, Soldiers Grove, WI 54655-7106 | 2011-11-22 |
| 1154698900 | Sue Ellen Johnson | Physical Therapy Assistant | 101 Sunshine Blvd, Soldiers Grove, WI 54655-7106 | 2011-11-22 |
| Find all providers in zip 54655 | ||||
| Taxonomy Code | 261QR1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rural Health |
| Definition to come... |
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| 1861904294 | Divine Savior Healthcare, Inc. | Clinic/Center | 102 Gillette Street, Pardeeville, WI 53954 | 2017-10-25 |
| 1366878449 | Amery Regional Medical Center, Inc | Clinic/Center | 357 Third Ave, Clear Lake, WI 54005-0177 | 2013-09-19 |
| 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 | SOLDIERS GROVE |
| Zip Code | 54655 |
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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.