NPIMap

Organization Active NPI

Thedacare Regional Medical Center-Neenah, Inc.

Doing business as ThedaCare Apothecary - Neenah

  • Community/Retail Pharmacy
  • Neenah, WI
National Provider Identifier
1336853175
Registry record updated Jun 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
THEDACARE REGIONAL MEDICAL CENTER-NEENAH, INC.
Doing business as
ThedaCare Apothecary - Neenah
Practice address
130 2ND St
Neenah, WI 54956-2883
Phone
(920) 454-5080
Fax
(920) 993-5078
NPI assigned
Jan 6, 2023
Last updated
Jun 5, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2024

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

Authorized official

Name
William Flett
Title
Cfo
Phone
(920) 454-4013

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X NU Primary
Long Term Care Pharmacy 3336L0003X NU

Addresses

Primary practice location

130 2ND St
Neenah, WI 54956-2883

Mailing address

130 2ND St
Neenah, WI 54956-2883
Phone (920) 454-5080

Other names 1

  • ThedaCare Apothecary - Neenah Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20230215001544 WI Part B Supplier - Pharmacy 8921090846 1 other NPI on this enrollment
Practice locations: Appleton, WI; Neenah, WI
O20250303001530 WI DME Supplier - Pharmacy 8921090846 Practice locations: Neenah, WI

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

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

National Provider Directory

National Provider Directory
Tax ID family
Theda Clark Reg Med CT15 organizations share this tax ID, including this one

Other organizations with this tax ID 14

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

View all 14

Locations

5320 W Michaels Dr
Grand Chute, WI 54913
Phone (920) 735-7650

1095 Midway Rd
Menasha, WI 54952
Phone (920) 720-3700

1516 S Commercial St
Neenah, WI 54956
Phone (920) 725-0077

2400 Witzel Ave
Ste C
Oshkosh, WI 54904
Phone (920) 203-6263

Practitioners & affiliated clinicians

Practitioners 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1672963200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717545600000",
    "number": "1336853175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 2ND ST",
            "city": "NEENAH",
            "state": "WI",
            "postal_code": "549562883",
            "telephone_number": "920-454-5080",
            "fax_number": "920-993-5078"
        },
        {
            "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": "920-454-5080",
            "fax_number": "920-993-5078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THEDACARE REGIONAL MEDICAL CENTER-NEENAH, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-06",
        "last_updated": "2024-06-05",
        "certification_date": "2024-06-05",
        "status": "A",
        "authorized_official_last_name": "FLETT",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "920-454-4013"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ThedaCare Apothecary - Neenah",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "ThedaCare Apothecary - Neenah",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Neenah, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2024; 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.