NPIMap

Organization Active NPI

St. Vincent Hospital-Hospital Sisters-Third Order of St. Francis

Doing business as St. Vincent Regional Cancer Center

  • Hematology & Oncology Physician
  • Green Bay, WI
National Provider Identifier
1184004236
Registry record updated Dec 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
Legal business name
ST. VINCENT HOSPITAL-HOSPITAL SISTERS-THIRD ORDER OF ST. FRANCIS
Doing business as
St. Vincent Regional Cancer Center
Practice address
1726 Shawano Ave
Green Bay, WI 54303-3216
Phone
(920) 498-4200
NPI assigned
Jun 4, 2015
Last updated
Dec 23, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
ST. VINCENT HOSPITAL-HOSPITAL SISTERS-THIRD ORDER OF ST. FRANCISAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 23, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ms. Patricia Allen
Title
Cfo
Phone
(920) 884-5660

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X NU Primary

Addresses

Primary practice location

1726 Shawano Ave
Green Bay, WI 54303-3216

Mailing address

PO Box 2594
Salt Lake City, UT 84110-2594

Other names 1

  • St. Vincent Regional Cancer Center Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address stvincent_stmary_stnicholas_stclare@ewd.direct.hshs.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20030421000001 WI Part A Provider - Hospital 5799694675 4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Sturgeon Bay, WI; Sheboygan, WI; Green Bay, WI; Oconto Falls, WI
O20040126000012 WI Part B Supplier - Clinic/Group Practice 5799694675 Receives reassigned benefits from 83 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Green Bay, WI; Oconto Falls, WI; Sheboygan, WI; Sturgeon Bay, WI

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1184004236. Details of each certification follow.

Hospital certification: CCN 520075

Legal name
ST VINCENT HOSPITAL-HOSPITAL SISTERS-THIRD ORDER OF ST FRANCIS
Doing business as
ST. VINCENT HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Sep 22, 2003
Beds
523
Ownership / control type
Church
Organization structure
CorporationNon-profit
Enrollment address
835 S Van Buren St
Green Bay, WI 54301-3526
Other Hospital Practice Location
Hospital subgroups
General, Acute care

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs on the same Medicare enrollment 6

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Hospital

Medicare Care Compare
Listed as
St Vincent HospitalCCN 520075 · All quality measures
Overall star rating
4 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Church
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory
Part of
St Vincent Hospital Physici

Ownership & related parties

All disclosed owners & managing parties 16

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Hospital Sisters Health System Inc Organization, Springfield, IL 5% Or Greater Direct Ownership Interest Oct 20, 2014 100%
Dennis Langenberg Individual Corporate Director Nov 1, 2018
Stephanie L Bakey Individual Corporate DirectorBoard Member Nov 1, 2021
Paula Hafeman Individual Corporate DirectorBoard Member Nov 1, 2021
Marcus Perez Individual Corporate DirectorBoard Member Nov 1, 2022
Patricia L Allen Individual Corporate OfficerCfo Jan 1, 2020
Corporate DirectorCfo Jan 1, 2020
Maureen Fagan Individual Corporate Director Nov 1, 2018
Jody Anne Boes Individual Corporate DirectorBoard Member Nov 1, 2021
Hospital Sisters Services Inc Organization, Springfield, IL 5% Or Greater Indirect Ownership Interest Oct 20, 2014 100%
Kyle J McCarty Individual Corporate DirectorBoard Member Nov 1, 2022
Nicole Schneider Individual Corporate DirectorBoard Member Nov 1, 2020
John Wagner Individual Corporate OfficerCoo Oct 15, 2022
Corporate DirectorCoo Oct 15, 2022
Damond Williams Boatwright Individual Corporate OfficerPresident/Ceo Jul 19, 2021
Michael Wickman Individual Corporate Officer Nov 1, 2018
Robert Erickson Individual Corporate OfficerPresident/Ceo Apr 29, 2024
Corporate DirectorPresident/Ceo Apr 29, 2024
W-2 Managing EmployeePresident/Ceo Apr 29, 2024
Travis Pitzen Individual Corporate OfficerDirector of Finance Sep 30, 2024
Corporate DirectorDirector of Finance Sep 30, 2024

Owners & managing parties with NPI records 2

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Practitioners 52

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 52

Affiliated clinicians 573

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 573

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1433376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1640217600000",
    "number": "1184004236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2594",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841102594"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1726 SHAWANO AVE",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543033216",
            "telephone_number": "920-498-4200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. VINCENT HOSPITAL-HOSPITAL SISTERS-THIRD ORDER OF ST. FRANCIS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ST. VINCENT HOSPITAL-HOSPITAL SISTERS-THIRD ORDER OF ST. FRANCIS",
        "enumeration_date": "2015-06-04",
        "last_updated": "2021-12-23",
        "certification_date": "2021-12-23",
        "status": "A",
        "authorized_official_last_name": "ALLEN",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "920-884-5660",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "stvincent_stmary_stnicholas_stclare@ewd.direct.hshs.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "1726 Shawano Ave",
            "city": "Green Bay",
            "state": "WI",
            "country_code": "US",
            "postal_code": "543033216",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "St. Vincent Regional Cancer Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "St. Vincent Regional Cancer Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Green Bay, WI

Sources for this page

Verify at the official NPI Registry.