NPIMap

Organization Active NPI

Door County Memorial Hospital

  • Clinic/Center
  • Sturgeon Bay, WI
National Provider Identifier
1295393452
Registry record updated Jun 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
DOOR COUNTY MEMORIAL HOSPITAL
Practice address
323 S 18TH Ave
Sturgeon Bay, WI 54235-1401
Phone
(920) 743-5566
NPI assigned
Jun 3, 2019
Last updated
Jun 3, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2019

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

Authorized official

Name
Andrew S Laluzerne, CPA
Title
Cfo
Phone
(920) 746-3729

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

323 S 18TH Ave
Sturgeon Bay, WI 54235-1401

Mailing address

323 S 18TH Ave
Sturgeon Bay, WI 54235-1401

Other identifiers 1

IdentifierTypeStateIssuer
01OtherPREVEA PARTNERED HEALTH PLAN

National Provider Directory

National Provider Directory
Tax ID family
Michael Brunobay PT CL16 organizations share this tax ID, including this one

Other organizations with this tax ID 15

Organizations that report the same tax identification number in the National Provider Directory.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1559520000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1559520000000",
    "number": "1295393452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "323 S 18TH AVE",
            "city": "STURGEON BAY",
            "state": "WI",
            "postal_code": "542351401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "323 S 18TH AVE",
            "city": "STURGEON BAY",
            "state": "WI",
            "postal_code": "542351401",
            "telephone_number": "920-743-5566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOOR COUNTY MEMORIAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-06-03",
        "last_updated": "2019-06-03",
        "status": "A",
        "authorized_official_last_name": "LALUZERNE",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "920-746-3729",
        "authorized_official_credential": "CPA"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREVEA PARTNERED HEALTH PLAN",
            "identifier": "01",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sturgeon Bay, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2019; 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.