St Nicholas Hospital-Sisters of the Third Order of St Francis

Organization Active NPI Nurse Practitioner · Sheboygan, WI

NPI 1275943243 · NPPES record last updated Dec 22, 2021

Key facts

NPI
1275943243
Entity type
Organization (NPI type 2)
Primary specialty
Nurse Practitioner 363L00000X
Legal business name
ST NICHOLAS HOSPITAL-SISTERS OF THE THIRD ORDER OF ST FRANCIS
Practice address
3100 Superior Ave
Sheboygan, WI 53081-1948
Phone
(920) 459-8300
NPI assigned
Apr 30, 2014
Organization subpart
Yes
Parent organization (as reported)
ST NICHOLAS HOSPITAL-SISTERS OF THE THIRD ORDER OF ST FRANCIS

Authorized official

Name
Andrew Bagnall
Title
Ceo
Phone
(920) 459-4705

Other NPIs on the same Medicare enrollment 2

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

Member organizations 2

Organizations listed as members of this organization in the National Provider Directory.

Practitioners 183

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 183

Medicare participation

Medicare fee-for-service enrollment
Enrolled in WI

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20040202001172 WI Part B Supplier - Clinic/Group Practice 8325931652 Receives reassigned benefits from 706 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Kohler, WI; Sheboygan, WI; Oostburg, WI; Plymouth, WI

National Provider Directory

Part of
St Nicholas Hospital-Sisters of Third Order of St Francis

Locations

1526 N Taylor Dr
Sheboygan, WI 53081
Phone (920) 457-2100

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner
Group: 193200000X MULTI-SPECIALTY GROUP
363L00000X Yes
Family Nurse Practitioner
Group: 193200000X MULTI-SPECIALTY GROUP
363LF0000X

Addresses

Primary practice location

3100 Superior Ave
Sheboygan, WI 53081-1948

Mailing address

3100 Superior Ave
Sheboygan, WI 53081-1948
Phone (920) 459-8300

Other names

  • St Nicholas Hospital Professional Services Group Doing business as

Electronic endpoints

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

Other providers in Sheboygan, WI

All providers in Sheboygan, WI · Nurse Practitioner in Wisconsin

Sources for this page

Verify at the official NPI Registry.