NPIMap

Organization Active NPI

Community Memorial Hospital

  • Non-Pharmacy Dispensing Site
  • Gillett, WI
National Provider Identifier
1407186141
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-Pharmacy Dispensing SiteTaxonomy code 332900000X
Legal business name
COMMUNITY MEMORIAL HOSPITAL
Practice address
340 N Green Bay Ave
Gillett, WI 54124-9325
Phone
(920) 855-2823
Fax
(920) 855-6343
NPI assigned
Dec 31, 2009
Last updated
Mar 7, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Authorized official

Name
Mr. Jason E Knox
Title
Pharmacy Manager
Phone
(920) 846-3444

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Non-Pharmacy Dispensing Site 332900000X Primary

Addresses

Primary practice location

340 N Green Bay Ave
Gillett, WI 54124-9325

Mailing address

340 N Green Bay Ave
Gillett, WI 54124-9325
Phone (920) 855-2823

Other names 1

  • CMH Primary Care Clinic, Remote Dispensing Registration Other name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address community_memorial_hospital_transitions_of_care2201223@ewd.direct.hshs.org Direct

National Provider Directory

National Provider Directory
Tax ID family
St Clare Memorial Hospital16 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": "1262217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1407186141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "340 N GREEN BAY AVE",
            "city": "GILLETT",
            "state": "WI",
            "postal_code": "541249325",
            "telephone_number": "920-855-2823",
            "fax_number": "920-855-6343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 N GREEN BAY AVE",
            "city": "GILLETT",
            "state": "WI",
            "postal_code": "541249325",
            "telephone_number": "920-855-2823",
            "fax_number": "920-855-6343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY MEMORIAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-31",
        "last_updated": "2023-03-07",
        "certification_date": "2021-12-23",
        "status": "A",
        "authorized_official_last_name": "KNOX",
        "authorized_official_first_name": "JASON",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PHARMACY MANAGER",
        "authorized_official_telephone_number": "920-846-3444",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "community_memorial_hospital_transitions_of_care2201223@ewd.direct.hshs.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "340 N Green Bay Ave",
            "city": "Gillett",
            "state": "WI",
            "country_code": "US",
            "postal_code": "541249325",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "CMH Primary Care Clinic, Remote Dispensing Registration",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "CMH Primary Care Clinic, Remote Dispensing Registration",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Gillett, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.