Mary C Phung, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

5896 Issued in WI

Practice address

707 S University Ave
Beaver Dam, WI 53916-3027

Phone

(920) 887-7181

NPI assigned

Aug 12, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Mary C Sherman Former name

Electronic endpoints 3

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Beaver Dam Community Hospitals Inc.Group PAC ID 2567370539, 64 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Marshfield Medical Center - Beaver Dam (MMC-BD) Hospital, Beaver Dam, WI, CCN 520076

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: him@marshfieldclinichealthsystem.cernerdirect.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Beaver Dam Community Hospitals Inc

  • Clinic/Center
  • Beaver Dam, WI
  • NPI 1972188555
  Medicare reassignment Care Compare group NPD
• Association of Hospital Anesthesiologists SC

  • Anesthesiology Physician
  • Neenah, WI
  • NPI 1720076474
  Medicare reassignment NPD
• Flambeau Hospital Inc

  • Clinic/Center
  • Park Falls, WI
  • NPI 1194317966
  Medicare reassignment NPD
• Flambeau Hospital Inc

  • Critical Access Hospital
  • Park Falls, WI
  • NPI 1700963048
  Medicare reassignment NPD
• Lakeview Medical Center Inc of Rice Lake

  • Clinic/Center
  • Rice Lake, WI
  • NPI 1093201832
  Medicare reassignment NPD
• Marshfield Clinic Inc

  • Clinic/Center
  • Marshfield, WI
  • NPI 1952347981
  Medicare reassignment NPD
• MCHS Hospitals Inc

  • Clinic/Center
  • Marshfield, WI
  • NPI 1093221434
  Medicare reassignment NPD
• MCHS Hospitals Inc

  • Critical Access Hospital
  • Ladysmith, WI
  • NPI 1952890873
  Medicare reassignment NPD
• Memorial Hospital Inc

  • Critical Access Hospital
  • Neillsville, WI
  • NPI 1346239373
  Medicare reassignment NPD
• Beaver Dam Community Hospitals Inc

  • Pharmacy
  • Beaver Dam, WI
  • NPI 1295771780
  NPD
• Lakeview Medical Center Inc of Rice Lake

  • Home Health Agency
  • Rice Lake, WI
  • NPI 1326139049
  NPD
• MCHS Hospitals Inc

  • Durable Medical Equipment & Medical Supplies
  • Eau Claire, WI
  • NPI 1558230847
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Beaver Dam Community Hospitals Inc

  • General Acute Care Hospital
  • Beaver Dam, WI
  • NPI 1023187416
  Care Compare affiliation
• Beaver Dam Community Hospitals Inc

  • Clinic/Center
  • Beaver Dam, WI
  • NPI 1508184896

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1407801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710720000000",
    "number": "1265841589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "707 S UNIVERSITY AVE",
            "city": "BEAVER DAM",
            "state": "WI",
            "postal_code": "539163027",
            "telephone_number": "920-887-7181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 S UNIVERSITY AVE",
            "city": "BEAVER DAM",
            "state": "WI",
            "postal_code": "539163027",
            "telephone_number": "920-887-7181"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "225 Memorial Dr",
            "address_purpose": "LOCATION",
            "city": "Berlin",
            "state": "WI",
            "postal_code": "549231243",
            "country_code": "US",
            "telephone_number": "920-361-5538",
            "fax_number": "920-361-5499",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PHUNG",
        "first_name": "MARY",
        "middle_name": "C",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-12",
        "last_updated": "2024-03-18",
        "certification_date": "2023-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "WI",
            "license": "5896",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1265841589",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mphung360033@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "225 Memorial Dr",
            "city": "Berlin",
            "state": "WI",
            "country_code": "US",
            "postal_code": "549231243",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "225 Memorial Dr",
            "city": "Berlin",
            "state": "WI",
            "country_code": "US",
            "postal_code": "549231243",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "him@marshfieldclinichealthsystem.cernerdirect.com",
            "affiliation": "N",
            "address_1": "707 S University Ave",
            "city": "Beaver Dam",
            "state": "WI",
            "country_code": "US",
            "postal_code": "539163027",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "SHERMAN",
            "middle_name": "C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jayson Persch, PHARMD
• Andrea Petersen, MSW
• Elizabeth Michael Peterson, M.D.
• Emily Peterson, MD
• Eugene P Philipp Jr., PSYD
• Physical Therapy Solutions, Inc.
• Danielle C Pickart
• Dena L Piechowski, NP
• Mary Jo Pleuss, CSW, ICS, CSAC
• Phyllis Ann Pleuss, LCSW

• Certified Registered Nurse Anesthetist in Beaver Dam, WI
• Providers in Beaver Dam, WI by specialty
• Certified Registered Nurse Anesthetist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.