Fort Memorial Hospital

Primary specialty

Non-Pharmacy Dispensing SiteTaxonomy code 332900000X

Legal business name

FORT MEMORIAL HOSPITAL

Practice address

611 Sherman Ave E
Fort Atkinson, WI 53538-1960

Phone

(952) 653-2528

NPI assigned

Jan 31, 2007

Organization subpart

No

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

Authorized official

Name

Ronald Meyer

Title

Medical Director

Phone

(952) 653-2528

Specialties & licenses 1

Addresses

Tax ID family

Fort Healthcare Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Fort Healthcare, Inc.

  • Skilled Nursing Facility
  • Fort Atkinson, WI
  • NPI 1447304340
  NPD tax ID

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

{
    "created_epoch": "1170201600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1665100800000",
    "number": "1376680330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6501 CITY WEST PKWY",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553443248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 SHERMAN AVE E",
            "city": "FORT ATKINSON",
            "state": "WI",
            "postal_code": "535381960",
            "telephone_number": "952-653-2528"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORT MEMORIAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-31",
        "last_updated": "2022-10-07",
        "certification_date": "2022-10-07",
        "status": "A",
        "authorized_official_last_name": "MEYER",
        "authorized_official_first_name": "RONALD",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "952-653-2528"
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Fort Healthcare Inc
• Fort Healthcare, Inc
• Fort Healthcare, Inc.
• Fort Healthcare, Inc.
• Fort Medical Equipment LLC
• Katherine L Fortney, OTR
• Kelly Foster, MS,CCC-SLP
• Stanley Fudala, M.D.
• Nathaniel J Fullerton, MD
• Garrison HDH LLC

• Non-Pharmacy Dispensing Site in Fort Atkinson, WI
• Providers in Fort Atkinson, WI by specialty
• Non-Pharmacy Dispensing Site in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2022; 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.