Thedacare Medical Center - New London, Inc.

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

THEDACARE MEDICAL CENTER - NEW LONDON, INC.

Practice address

1405 Mill St
New London, WI 54961-2155

Phone

(920) 531-2092

Fax

(920) 531-2098

NPI assigned

Aug 6, 2009

Last updated

Jan 3, 2024By 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

Mr. William Flett

Title

Cfo

Phone

(920) 454-4013

Specialties & licenses 1

Addresses

Other identifiers 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

New London Family Medic5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

• New London Family Medical Center Inc

  dba New London Family Medical Center

  • Non-Pharmacy Dispensing Site
  • New London, WI
  • NPI 1972928463
  NPD tax ID
• Thedacare Medical Center - New London, Inc

  • Emergency Medicine Physician
  • New London, WI
  • NPI 1811908858
  NPD tax ID
• Thedacare Medical Center - New London, Inc

  • Ambulance
  • New London, WI
  • NPI 1992848790
  NPD tax ID
• Thedacare Medical Center - New London, Inc.

  • Anesthesiology Physician
  • New London, WI
  • NPI 1073611083
  NPD tax ID

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

{
    "created_epoch": "1249516800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704240000000",
    "number": "1386875466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 NEENAH CTR",
            "city": "NEENAH",
            "state": "WI",
            "postal_code": "549563070",
            "telephone_number": "920-830-8900",
            "fax_number": "920-830-5910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1405 MILL ST",
            "city": "NEW LONDON",
            "state": "WI",
            "postal_code": "549612155",
            "telephone_number": "920-531-2092",
            "fax_number": "920-531-2098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THEDACARE MEDICAL CENTER - NEW LONDON, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-06",
        "last_updated": "2024-01-03",
        "certification_date": "2024-01-03",
        "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",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "11010410",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• The Pharmacy of New London Inc. (Jernegan's Health Mart Pharmacy)
• Thedacare Medical Center - New London, Inc
• Thedacare Medical Center - New London, Inc
• Thedacare Medical Center - New London, Inc
• Thedacare Medical Center - New London, Inc.
• Thedacare Medical Center - New London, Inc.
• Thedacare, Incorporated (ThedaCare Physicians)
• Thedacare, Incorporated
• Thompsons RX Wisconsin LLC (Jernegans Pharmacy)
• Thompsons RX Wisconsin LLC (Jernegans Pharmacy)

• Clinical Medical Laboratory in New London, WI
• Providers in New London, WI by specialty
• Clinical Medical Laboratory in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.