Algoma Medical Center

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

2952 Issued in WI

Legal business name

ALGOMA MEDICAL CENTER

Doing business as

Algoma Medical Center & LTC

Practice address

1510 Fremont St
Algoma, WI 54201-1948

Phone

(920) 487-5511

Fax

(920) 487-2668

NPI assigned

Nov 21, 2005

Last updated

Dec 7, 2011By 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

Jeanne M Brandt, N.H.A., M.B.A.

Title

Nursing Home Administrator

Phone

(920) 487-5511

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Algoma Medical Center & LTC Doing business as

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

{
    "created_epoch": "1132531200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1323216000000",
    "number": "1215910690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1510 FREMONT ST",
            "city": "ALGOMA",
            "state": "WI",
            "postal_code": "542011948",
            "telephone_number": "920-487-5511",
            "fax_number": "920-487-2668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1510 FREMONT ST",
            "city": "ALGOMA",
            "state": "WI",
            "postal_code": "542011948",
            "telephone_number": "920-487-5511",
            "fax_number": "920-487-2668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALGOMA MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-21",
        "last_updated": "2011-12-07",
        "status": "A",
        "authorized_official_last_name": "BRANDT",
        "authorized_official_first_name": "JEANNE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "NURSING HOME ADMINISTRATOR",
        "authorized_official_telephone_number": "920-487-5511",
        "authorized_official_credential": "N.H.A., M.B.A."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "WI",
            "license": "2952",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "20162700",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Algoma Medical Center & LTC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Aurora Pharmacy Inc (Aurora Pharmacy)
• Bellin Memorial Hospital Inc (Bellin Health Algoma)
• Bellin Psychiatric Center Inc (Bellin Behavior Health Algoma)
• William F Bluett, PT
• Allycia E Bretl, LCSW, SAC-IT

• Skilled Nursing Facility in Algoma, WI
• Providers in Algoma, WI by specialty
• Skilled Nursing Facility in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2011; 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.