COMMUNITY MEMORIAL HOSPITAL, INCORPORATED (NPI# 1386925915) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386925915 |
| Entity Type | Organization |
| Organization Name | COMMUNITY MEMORIAL HOSPITAL, INCORPORATED |
| Other Organization Name | D/B/A BREAST SURGERY EXPERTS OF NORTHEAST WISCONSIN |
| Practice Address |
835 S Main St Oconto Falls WI 54154-1282 |
| Mailing Address |
25630 Network Pl Chicago IL 60673-1256 |
| Practice Telephone | 9203603787 |
| Practice Fax Number | 8888480225 |
| Mailing Telephone | 9203603787 |
| Mailing Fax Number | 8888480225 |
| Enumeration Date | 2011-09-09 |
| Last Update Date | 2011-09-09 |
| Authorized Official Name | DANIEL DEGROOT (CEO) |
| Authorized Official Telephone | 9208463444 |
| Is Organization Subpart | Y |
| Parent Organization Name | COMMUNITY MEMORIAL HOSPITAL, INCORPORATED |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208600000X | Surgery | 395597-20 | WI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | CMH NPI | 1851477913 | 01 |
| WI | PROVIDER | 1750302089 | 01 |
| Other Name | Type Code |
|---|---|
| d/b/a Breast Surgery Experts of Northeast Wisconsin | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801177035 | Community Memorial Hospital, Incorporated | Surgery | 200 Theda Clark Medical Plz, Suite 210, Neenah, WI 54956-2721 | 2011-09-01 |
| 1093096224 | Community Memorial Hospital, Incorporated | Surgery | 1726 Shawano Ave, Green Bay, WI 54303-3216 | 2011-09-01 |
| 1437470572 | Community Memorial Hospital, Incorporated | Physical Therapist | 103 1st St, Oconto, WI 54153-1117 | 2010-06-11 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | COMMUNITY MEMORIAL HOSPITAL, INCORPORATED | 800 Memorial Dr Ste 1, Spring Valley, MN 55975-1055 |
| Street Address |
835 S MAIN ST |
| City | OCONTO FALLS |
| State | WI |
| Zip Code | 54154-1282 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033682620 | Baycare Clinic, LLP | Neurological Surgery | 835 S Main St, Oconto Falls, WI 54154-1282 | 2019-01-07 |
| 1184117194 | Anna Lopas | Physical Therapist | 835 S Main St, Oconto Falls, WI 54154-1282 | 2018-06-13 |
| 1417316738 | St. Clare Memorial Hospital, Inc | Surgery | 835 S Main St, Suite 3, Oconto Falls, WI 54154-1241 | 2016-02-15 |
| 1043686967 | Jessica Rae Witt | Nurse Practitioner | 835 S Main St, Suite 1, Oconto Falls, WI 54154-1282 | 2015-08-14 |
| 1700268513 | Katie Halverson | Physical Therapist | 835 S Main St, Oconto Falls, WI 54154-1282 | 2015-06-29 |
| 1073994976 | Mengxia Zhang | Physician Assistant | 835 S Main St, Oconto Falls, WI 54154-1282 | 2015-06-16 |
| 1801210240 | Glenda Weigner | Nurse Practitioner | 835 S Main St, Ste 1, Oconto Falls, WI 54154-1282 | 2014-02-05 |
| 1548504996 | Dawn R Giese | Nurse Practitioner | 835 S Main St, Ste 1, Oconto Falls, WI 54154-1282 | 2012-11-23 |
| 1023376910 | Amy M Romandine Kratz | Family Medicine | 835 S Main St, Oconto Falls, WI 54154-1282 | 2012-04-27 |
| 1194034850 | Forefront Dermatology, S.c. | Dermatology | 835 S Main St, Suite 1, Oconto Falls, WI 54154 | 2010-09-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578967220 | St Vincent Hospital-hospital Sisters-third Order of St Francis | Clinic/Center | 853 South Main St, Suite A, Oconto Falls, WI 54154 | 2014-10-09 |
| 1194125534 | New Womens Care S C | Obstetrics & Gynecology | 855 South Main St., Oconto Falls, WI 54154 | 2014-09-03 |
| 1881869949 | Shari L Pfankuch | Occupational Therapist | 100 E Highland Drive, Sharpe Care, Oconto Falls, WI 54154 | 2008-04-29 |
| 1861666588 | Angela Irene Vancleve | Occupational Therapy Assistant | 100 E. Highland Drive, Oconto Falls, WI 54154 | 2008-04-14 |
| 1861793440 | Debra Kay Munes | Dentist | 248 North Main Street, Oconto Falls, WI 54154 | 2010-11-12 |
| 1851565774 | Marcy Ann Neitzer | Physical Therapy Assistant | 100 E Highland Dr, Oconto Falls, WI 54154 | 2008-04-22 |
| 1427168863 | Oconto Falls Dental Sc | Dentist | 248 N Main St, Oconto Falls, WI 54154 | 2006-08-30 |
| 1447235148 | David J Bell | Counselor | 107 E Highland Dr, Oconto Falls, WI 54154 | 2005-12-14 |
| 1306831052 | Heyde Health System Oconto Falls LLC | Skilled Nursing Facility | 100 E Highland Dr, Oconto Falls, WI 54154-1001 | 2005-09-19 |
| 1609426337 | Oconto Falls Nursing and Rehab LLC | Skilled Nursing Facility | 100 E Highland Dr, Oconto Falls, WI 54154-1001 | 2019-09-15 |
| Find all providers in zip 54154 | ||||
| Taxonomy Code | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417316738 | St. Clare Memorial Hospital, Inc | Surgery | 835 S Main St, Suite 3, Oconto Falls, WI 54154-1241 | 2016-02-15 |
| 1912936055 | Kevin G Hibbett | Surgery | 835 S Main St, Suite 1, Oconto Falls, WI 54154-1282 | 2006-07-01 |
| 1639166853 | R Scott Liebl | Surgery | 835 S Main St, Suite 1, Oconto Falls, WI 54154-1241 | 2005-10-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598310195 | Matthew Laviolette | Surgery | Medical College of Wisconsin, 8701 Watertown Plank Rd., Surgical Oncology, Milwaukee, WI 53226 | 2019-08-09 |
| 1659832855 | Benjamin David Seadler | Surgery | Mcw, Department of Surgery, 8701 Watertown Plank Road, Milwaukee, WI 53226 | 2019-03-29 |
| 1861969149 | Watertown Physician Practices LLC | Surgery | 123 Hospital Dr Ste 2009, Watertown, WI 53098-3320 | 2018-10-25 |
| 1356847644 | Laura K Krecko | Surgery | Uw Hospital and Clinics 600 Highland Avenue, Madison, WI 53792-0001 | 2018-04-04 |
| 1447785332 | Patrick Beard Schwartz | Surgery | Uw Hopsitals and Clinics, 600 Highland Ave., Madison, WI 53792-0001 | 2017-04-27 |
| 1700263720 | Marianna Dubovska | Surgery | 902 Riverside Dr Ste 201, Waupaca, WI 54981-1992 | 2015-04-28 |
| 1366833394 | Beaver Dam Community Hospitals, Inc | Surgery | 705 S University Ave Ste 350, Beaver Dam, WI 53916 | 2015-02-12 |
| 1972901262 | The Healthy Vein, Sc | Surgery | N79w14684 Appleton Ave, Menomonee Falls, WI 53051-4308 | 2014-12-18 |
| 1326453200 | Chey V Collura | Surgery | 2700 W 9th Ave Ste 310, Oshkosh, WI 54904 | 2014-06-30 |
| 1538570338 | Nicholas Sich | Surgery | 2901 W Kinnickinnic River Pkwy Dept Ste 540, Milwaukee, WI 53215-3677 | 2014-05-14 |
| Find all providers with the same taxonomy | ||||
| City | OCONTO FALLS |
| Zip Code | 54154 |
Please comment or provide details below to improve the information on COMMUNITY MEMORIAL HOSPITAL, INCORPORATED.
| 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.