Theda Clark OB Hospitalists SC

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

Legal business name

THEDA CLARK OB HOSPITALISTS SC

Practice address

130 2ND St
Neenah, WI 54956-2883

Phone

(920) 729-7105

Fax

(920) 831-8306

NPI assigned

Aug 29, 2023

Last updated

Aug 29, 2023By 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

Eric G Eberts, MDNPI 1790780708

Title

President

Phone

(920) 729-7105

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Locations

Practitioners 58

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Eric G Eberts, M.D.

  • Obstetrics & Gynecology Physician
  • Neenah, WI
  • NPI 1790780708
  Medicare reassignment NPD Authorized official
• Anna J Igler, MD

  • Obstetrics & Gynecology Physician
  • Green Bay, WI
  • NPI 1508096017
  Medicare reassignment Care Compare group NPD
• Sara Helena Tikkanen Swift, M.D

  • Obstetrics & Gynecology Physician
  • Neenah, WI
  • NPI 1407082381
  Medicare reassignment Care Compare group NPD
• Rebecca R Downs, M.D.

  • Obstetrics & Gynecology Physician
  • Madison, WI
  • NPI 1467686766
  Medicare reassignment NPD
• Valary R Gass, M.D.

  • Obstetrics & Gynecology Physician
  • Neenah, WI
  • NPI 1558533695
  Medicare reassignment NPD
• Gretchen E Rakiec Augustine, DO

  • Obstetrics & Gynecology Physician
  • Appleton, WI
  • NPI 1487041927
  Medicare reassignment NPD
• Amanda Anne Reed

  • Obstetrics & Gynecology Physician
  • Appleton, WI
  • NPI 1275707556
  Medicare reassignment NPD
• Alison Rae Sampson, D.O.

  • Obstetrics & Gynecology Physician
  • Marshfield, WI
  • NPI 1003038381
  Medicare reassignment NPD
• Adriana Origel Schaufelberger, MD, MPH

  • Obstetrics & Gynecology Physician
  • Neenah, WI
  • NPI 1396846481

  Single Specialty

  Medicare reassignment NPD
• Marissa Renee Schloesser

  • Obstetrics & Gynecology Physician
  • Neenah, WI
  • NPI 1366785958
  Medicare reassignment NPD
• Effie E. Siomos, M.D.

  • Obstetrics & Gynecology Physician
  • Berlin, WI
  • NPI 1376589572
  Medicare reassignment NPD
• Maria Kristin Vandenberg, M.D.

  • Obstetrics & Gynecology Physician
  • Neenah, WI
  • NPI 1255565701
  Medicare reassignment NPD

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

{
    "created_epoch": "1693267200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1693267200000",
    "number": "1295510196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3232 N BALLARD RD STE 100",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549118804",
            "telephone_number": "920-729-7105",
            "fax_number": "920-831-8306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 2ND ST",
            "city": "NEENAH",
            "state": "WI",
            "postal_code": "549562883",
            "telephone_number": "920-729-7105",
            "fax_number": "920-831-8306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THEDA CLARK OB HOSPITALISTS SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-29",
        "last_updated": "2023-08-29",
        "certification_date": "2023-08-25",
        "status": "A",
        "authorized_official_last_name": "EBERTS",
        "authorized_official_first_name": "ERIC",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "920-729-7105",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maiker Keren Thao-Yang, R.N.
• The Center for Aesthetics & Plastic Surgery S.C.
• The Neuroscience Group of Northeast Wisconsin SC (Neuroscience Group)
• The Neuroscience Group of Northeast Wisconsin, SC (Neuroscience Group)
• Theda Clark Hospital
• Theda Clark Pharmacy
• Thedacare
• Thedacare Regional Medical Center - Neenah, Inc
• Thedacare Regional Medical Center - Neenah, Inc.
• Thedacare Regional Medical Center - Neenah, Inc. (ThedaCare Apothecary-Neenah)

• Obstetrics & Gynecology Physician in Neenah, WI
• Providers in Neenah, WI by specialty
• Obstetrics & Gynecology Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.