MOUNDVIEW MEMORIAL HOSPITAL & CLINICS, INC. (NPI# 1720147366) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720147366 |
| Entity Type | Organization |
| Organization Name | MOUNDVIEW MEMORIAL HOSPITAL & CLINICS, INC. |
| Other Organization Name | GUNDERSEN MOUNDVIEW HOSPITAL AND CLINICS, INC. |
| Practice Address |
402 W Lake St Friendship WI 53934-9699 |
| Mailing Address |
Po Box 40 Friendship WI 53934-0040 |
| Practice Telephone | 6083393331 |
| Mailing Telephone | 6083393331 |
| Enumeration Date | 2006-12-08 |
| Last Update Date | 2019-05-13 |
| Authorized Official Name | FRANK PEREZ-GUERRA (CEO) |
| Authorized Official Telephone | 6083396814 |
| Is Organization Subpart | Y |
| Parent Organization Name | MOUNDVIEW MEMORIAL HOSPITAL & CLINICS, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 275N00000X | Medicare Defined Swing Bed Unit | Hospital Units |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 11012000 | 05 | |
| WI | MEDICARE RAILROAD | CR0660 | 01 |
| Other Name | Type Code |
|---|---|
| Gundersen Moundview Hospital and Clinics, Inc. | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861829194 | Moundview Memorial Hospital & Clinics, Inc. | Clinic/Center | 207 N Pioneer Park Rd, Unit 8, Westfield, WI 53964-9092 | 2013-10-01 |
| 1962560334 | Moundview Memorial Hospital & Clinics, Inc. | Clinic/Center | 402 W. Lake St., Friendship, WI 53934 | 2006-12-05 |
| Street Address |
402 W LAKE ST |
| City | FRIENDSHIP |
| State | WI |
| Zip Code | 53934-9699 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467446492 | Stephen Charles Paulk | Specialist | 402 W Lake St, Friendship, WI 53934-9699 | 2005-09-06 |
| 1336621440 | Jessica Marie Johnson | Nurse Practitioner | 402 W Lake St, Friendship, WI 53934-9699 | 2018-09-05 |
| 1235646654 | Deena Marie Kedrowski | Pharmacist | 402 W Lake St, Friendship, WI 53934-9699 | 2018-01-08 |
| 1104374867 | Virginia Lee Batie | Registered Nurse | 402 W Lake St, Friendship, WI 53934-9699 | 2016-09-12 |
| 1740733617 | Barbara Theisen | Registered Nurse | 402 W Lake St, Friendship, WI 53934-9699 | 2016-07-27 |
| 1861879462 | Heather Jean Greiling | Nurse Practitioner | 402 W Lake St, Friendship, WI 53934-9699 | 2015-05-03 |
| 1184966509 | David L Rebedew | Family Medicine | 402 W Lake St, Friendship, WI 53934-9699 | 2013-03-24 |
| 1093051617 | Mile Bluff Medical Center Inc | Durable Medical Equipment & Medical Supplies | 402 W Lake St, Friendship, WI 53934-9699 | 2012-12-31 |
| 1992968291 | Danielle M Hill | Family Medicine | 402 W Lake St, Friendship, WI 53934-9699 | 2008-07-07 |
| 1255513529 | Perry S Damian | Family Medicine | 402 W Lake St, Friendship, WI 53934-9699 | 2007-11-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396234837 | Gundersen Clinic Ltd | Optometrist | 402a W Lake St, Friendship, WI 53934 | 2018-05-09 |
| 1780972174 | Emily Burzynski Clark | Speech-Language Pathologist | 210 S. Park St, Friendship, WI 53934 | 2011-07-19 |
| 1942492459 | Gene P. Wegner, Sc | Radiology | 302 W Lake Street, Friendship, WI 53934 | 2007-08-17 |
| 1962560334 | Moundview Memorial Hospital & Clinics, Inc. | Clinic/Center | 402 W. Lake St., Friendship, WI 53934 | 2006-12-05 |
| 1982770723 | Sheryl J. Obernberger | Nurse Practitioner | 402 West Lake St., Friendship, WI 53934 | 2006-11-24 |
| 1992894927 | Robert J Schindlbeck | Dentist | 320 W Lake St, Friendship, WI 53934 | 2006-10-11 |
| 1336173095 | Roche A Cri Clinic Sc | Family Medicine | 302 W. Lake St., Friendship, WI 53934 | 2006-07-10 |
| 1174514699 | Ann M Anderson | Nurse Practitioner | 302 West Lake St, Friendship, WI 53934 | 2005-11-03 |
| 1801881388 | Mark E Hatton | Family Medicine | 402 West Lake Street, Friendship, WI 53934 | 2005-09-12 |
| 1780064956 | Andrew Schmitz | Counselor | 302 W Lake St, Friendship, WI 53934 | 2015-06-03 |
| Find all providers in zip 53934 | ||||
| Taxonomy Code | 275N00000X |
| Grouping | Hospital Units |
| Classification | Medicare Defined Swing Bed Unit |
| A unit of a hospital that has a Medicare provider agreement and has been granted approval from HCFA to provide post-hospital extended care services and be reimbursed as a swing-bed unit. |
| Notes: Source: Code of Federal Regulations #42, Section 482.66. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407096266 | Ascension Good Samaritan Hospital, Inc. | Medicare Defined Swing Bed Unit | 601 S. Center Ave, Merrill, WI 54452-3404 | 2009-03-05 |
| 1306051990 | St. Joseph's Health Services, Inc. | Medicare Defined Swing Bed Unit | 400 Water Ave., Hillsboro, WI 54634 | 2007-05-14 |
| 1194348896 | Thedacare Regional Medical Center-neenah, Inc. | Medicare Defined Swing Bed Unit | 130 2nd St, Neenah, WI 54956-2883 | 2020-05-28 |
| 1326661026 | Thedacare Regional Medical Center - Appleton, Inc. | Medicare Defined Swing Bed Unit | 1818 N Meade St, Appleton, WI 54911-3454 | 2020-05-28 |
| 1346716263 | Mchs Hospitals, Inc. | Medicare Defined Swing Bed Unit | 900 College Ave W, Ladysmith, WI 54848-2116 | 2018-10-18 |
| 1689151599 | Oconto Hospital & Medical Center Inc | Medicare Defined Swing Bed Unit | 820 Arbutus Ave, Oconto, WI 54153-2004 | 2018-07-24 |
| 1659786457 | Mercy Health System Corporation | Medicare Defined Swing Bed Unit | N2950 State Road 67, Lake Geneva, WI 53147-2655 | 2014-07-01 |
| 1326349135 | St Clare Memorial Hospital, Inc | Medicare Defined Swing Bed Unit | 855 S Main St, Oconto Falls, WI 54154-1241 | 2010-11-10 |
| 1720252893 | Aurora Medical Center of Manitowoc County, Inc. | Medicare Defined Swing Bed Unit | 5000 Memorial Dr, Two Rivers, WI 54241-3900 | 2008-04-18 |
| 1265618979 | Thedacare Medical Center - Shawano, Inc. | Medicare Defined Swing Bed Unit | 100 County Road B, Shawano, WI 54166-7072 | 2008-01-11 |
| Find all providers with the same taxonomy | ||||
| City | FRIENDSHIP |
| Zip Code | 53934 |
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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.