Agnesian Healthcare Enterprises LLC

Primary specialty

Oxygen Equipment & Supplies (DME)Taxonomy code 332BX2000X

Legal business name

AGNESIAN HEALTHCARE ENTERPRISES LLC

Doing business as

Agnesian Home Oxygen

Practice address

239 Trowbridge Dr
Fond Du Lac, WI 54937-9180

Phone

(920) 907-5364

Fax

(920) 923-7957

NPI assigned

Feb 17, 2006

Last updated

Apr 20, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Steven N Little

Title

SVP & Cfo

Phone

(920) 926-5402

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Agnesian Home Oxygen Doing business as

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• SSM Health Care of Wisconsin, Inc

  dba SSM Health St Mary's Hospital - Madison

  • Psychiatric Hospital Unit
  • Madison, WI
  • NPI 1386688240

  Member Of

  NPD member

Locations

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

{
    "created_epoch": "1140134400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1184699704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "239 TROWBRIDGE DR",
            "address_2": "PO BOX 1031",
            "city": "FOND DU LAC",
            "state": "WI",
            "postal_code": "549379180",
            "telephone_number": "920-907-5364",
            "fax_number": "920-923-7957"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "239 TROWBRIDGE DR",
            "city": "FOND DU LAC",
            "state": "WI",
            "postal_code": "549379180",
            "telephone_number": "920-907-5364",
            "fax_number": "920-923-7957"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AGNESIAN HEALTHCARE ENTERPRISES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-17",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "LITTLE",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "SVP & CFO",
        "authorized_official_telephone_number": "920-926-5402"
    },
    "taxonomies": [
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WI CHRONIC DISEASE PROGRA",
            "identifier": "41739100",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIRSP",
            "identifier": "41739100",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41739100",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Agnesian Home Oxygen",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Actra Rehabilitation Associates Inc (NovaCare Prosthetics & Orthotics)
• Nathan Edward Adams, APNP, ACNP-BC
• Thomas Adler
• Advance Therapy Center, Inc
• Agnesian Healthcare (Fond Du Lac Regional Clinic)
• Agnesian Healthcare Enterprises LLC (Agnesian Health Shoppe)
• Agnesian Healthcare Inc (SSM Health Fond Du Lac Regional Clinic)
• Agnesian Healthcare Inc (SSM Health Pharmacy)
• Agnesian Healthcare Inc (Fond du Lac Regional Optical)
• Agnesian Healthcare Inc (Fond Du Lac Regional Clinc)

• Oxygen Equipment & Supplies (DME) in Fond Du Lac, WI
• Providers in Fond Du Lac, WI by specialty
• Oxygen Equipment & Supplies (DME) in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.