Door County Memorial Hospital
Organization Active NPI Skilled Nursing Facility · Sturgeon Bay, WI
NPI 1083718399 · NPPES record last updated Apr 6, 2022
Key facts
- NPI
- 1083718399
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- Legal business name
- DOOR COUNTY MEMORIAL HOSPITAL
- Practice address
- 323 S 18TH Ave
Sturgeon Bay, WI 54235-1401 - Phone
- (920) 743-5566
- NPI assigned
- Sep 8, 2006
- Organization subpart
- No
Authorized official
- Name
- Mr. Andrew S Laluzerne
- Title
- Cfo
- Phone
- (920) 746-3729
Owners & managing parties with NPI records 20
-
Dorene E. Dempster, M.D.
-
Joseph Joshua Rebhan, M.D.
-
Michael R. St Jean, M.D.
Other NPIs with the same Medicare PAC ID 7
Corporate family (same tax ID) 15
Member of 1
Facilities with the same owner 8
Practitioners 85
-
Adam Ross Alexander, D.O.
-
Rick James Avery, MD
-
Ellen Cynthia Barton, DPM
-
Marc Paul Binard, M.D.
-
Paul Steven Board, M.D.
-
Antonino Bommarito, PA-C
-
Cassaundra N Bratz, LPC
-
Allycia E Bretl, LCSW, SAC-IT
-
Beth Ann Brunette, APNP
-
Kirsten Lisa Carlson, LPC
-
Candace Agress Cohen, M.D.
-
Courtney Rheins Curry, APNP
-
Lauren Daoust, LCSW
-
Dorene E. Dempster, M.D.
-
Heidi Derbick, FNP
-
Martin Finck, M.D.
-
Shannon James Gallagher, MD, MPH
-
Sheryl A Gauthier, PA-C
Affiliated clinicians 5
-
Paul Steven Board, M.D.
-
James Freeman Heise, M.D.
-
Richard Anthony Hogan, M.D.
-
Kelton J Reitz, D.O.
Medicare Care Compare: Nursing home
- Listed as
- Door County Memorial Hospital SNF
- Overall star rating
- ★★★★★ 5 of 5
- Health inspections
- ★★★★☆ 4 of 5
- Staffing
- ★★★★★ 5 of 5
- Quality measures
- ★★★★★ 5 of 5
- Type
- Medicare and Medicaid
- Ownership
- Non profit - Corporation
- Certified
- Oct 1, 1984
- Medicare certification status
- Active
- Certified beds
- 32 · 30.9 residents per day on average
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
Skilled nursing facility certification: CCN 525377
- Legal name
- DOOR COUNTY MEMORIAL HOSPITAL
- Doing business as
- PETE AND JELAINE HORTON CENTER
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Oct 1, 1984
- Last certification
- Feb 19, 2025
- Beds
- 32
- Ownership / control type
- Nonprofit Corporation
- Organization structure
- Corporation · Non-profit
- Enrollment address
- 323 S 18TH Ave
Sturgeon Bay, WI 54235-1401 - Nursing home name
- DOOR COUNTY MEMORIAL HOSPITAL SNF
All disclosed owners & managing parties 26
| Name | Role | Since | Share |
|---|---|---|---|
| Edgar K Collison |
Corporate Director |
May 14, 2025 | |
| Operational/Managerial Control | May 14, 2025 | ||
| Adp of the SNF | May 14, 2025 | ||
| |
Adp of the SNF | Feb 14, 2025 | |
| Patricia M Vickman |
Corporate Director |
Oct 1, 2017 | |
| Operational/Managerial Control | Oct 1, 2017 | ||
| Adp of the SNF | Oct 1, 2017 | ||
| Pauline M Helm |
Corporate Director |
Jan 1, 2023 | |
| Operational/Managerial Control | Jan 1, 2023 | ||
| Adp of the SNF | Jan 1, 2023 | ||
| |
Adp of the SNF | Jan 30, 2025 | |
| Andrew S Laluzerne |
Corporate Officer |
Oct 29, 2018 | |
| Operational/Managerial Control | Oct 29, 2018 | ||
| Adp of the SNF | Oct 29, 2018 | ||
| |
Adp of the SNF | Feb 14, 2025 | |
| Joseph Joshua Rebhan |
Corporate Director | Jan 1, 2026 | |
| Operational/Managerial Control | Jan 1, 2026 | ||
| Adp of the SNF | Jan 1, 2026 | ||
| Martha S Ziegelbauer |
Corporate Director |
Jan 1, 2022 | |
| Operational/Managerial Control | Jan 1, 2022 | ||
| Adp of the SNF | Jan 1, 2022 | ||
| Michael R St Jean |
Corporate Director |
Jan 1, 2025 | |
| Operational/Managerial Control | Jan 1, 2025 | ||
| Adp of the SNF | Jan 1, 2025 | ||
| Jamie D Alberts |
Corporate Director |
Jan 1, 2021 | |
| Operational/Managerial Control | Jan 1, 2021 | ||
| Adp of the SNF | Jan 1, 2021 | ||
| Caroline M Urban |
Operational/Managerial Control | Jul 1, 2024 | |
| Adp of the SNF | Jul 1, 2024 | ||
| Tammy a Sternard |
Corporate Director |
Jan 1, 2025 | |
| Operational/Managerial Control | Jan 1, 2025 | ||
| Adp of the SNF | Jan 1, 2025 | ||
| Joel C Kitchens |
Corporate Director |
Jan 1, 2021 | |
| Operational/Managerial Control | Jan 1, 2021 | ||
| Adp of the SNF | Jan 1, 2021 | ||
| Nancy Z Bohrman |
Operational/Managerial Control | Jul 1, 2024 | |
| Adp of the SNF | Jul 1, 2024 | ||
| St Vincent Hospital-Hospital Sisters-Third Order of St Francis |
Operational/Managerial Control | Oct 28, 2016 | |
| Adp of the SNF | Feb 14, 2025 | ||
| Erin Rae Helgeson |
Corporate Director |
Jan 1, 2024 | |
| Operational/Managerial Control | Jan 1, 2024 | ||
| Adp of the SNF | Jan 1, 2024 | ||
| Dorene E Dempster |
Corporate Director |
Jan 1, 2019 | |
| Operational/Managerial Control | Jan 1, 2019 | ||
| Adp of the SNF | Jan 1, 2019 | ||
| Bradley S Andreae |
Corporate Director |
Jan 1, 2024 | |
| Operational/Managerial Control | Jan 1, 2024 | ||
| Adp of the SNF | Jan 1, 2024 | ||
| Jeffrey J Rabas |
Corporate Director |
Jan 1, 2022 | |
| Operational/Managerial Control | Jan 1, 2022 | ||
| Adp of the SNF | Jan 1, 2022 | ||
| Jonathan L Jarosh |
Corporate Director |
Jan 1, 2024 | |
| Operational/Managerial Control | Jan 1, 2024 | ||
| Adp of the SNF | Jan 1, 2024 | ||
| Maria Chona S Antonio |
Operational/Managerial Control | Jul 1, 2024 | |
| Adp of the SNF | Jul 1, 2024 | ||
| Robert Erickson |
Corporate Director |
May 15, 2024 | |
| Operational/Managerial Control | May 15, 2024 | ||
| Adp of the SNF | May 15, 2024 | ||
| Brian C Stephens |
Corporate Officer |
Jan 6, 2019 | 100% |
| Operational/Managerial Control |
Jan 6, 2019 | ||
| Adp of the SNF | Jan 6, 2019 | ||
| Corwin D Dahl |
Corporate Director |
Jan 1, 2021 | |
| Operational/Managerial Control | Jan 1, 2021 | ||
| Adp of the SNF | Jan 1, 2021 | ||
| Andrew Richmond |
Corporate Director |
Oct 1, 2017 | |
| Operational/Managerial Control | Oct 1, 2017 | ||
| Adp of the SNF | Oct 1, 2017 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20111214000197 | WI | Part a Provider - Skilled Nursing Facility | 5395735088 | Practice locations: Sturgeon Bay, WI |
National Provider Directory
- Tax ID family
- Door Cnty Mem HSP
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | WI | Yes |
Addresses
Primary practice location
323 S 18TH Ave
Sturgeon Bay, WI 54235-1401
Mailing address
323 S 18TH Ave
Sturgeon Bay, WI 54235-1401
Phone (920) 743-5566
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083718399 | Medicaid | WI |
Other names
- Pete and Jelaine Horton Center
Other providers in Sturgeon Bay, WI
- Door County Department of Community Programs
- Door County Dept of Community Programs
- Door County Dept of Social Services
- Door County Emergency Physicians, LLC
- Door County Eye Associates, Inc
- Door County Memorial Hospital
- Door County Memorial Hospital
- Door County Memorial Hospital
- Door County Memorial Hospital
- Door County Memorial Hospital
All providers in Sturgeon Bay, WI · Skilled Nursing Facility in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 6, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.