Community Memorial Hospital

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

Organization subpart

No

Name

Mr. Jason E Knox

Title

Pharmacy Manager

Phone

(920) 846-3444

Tax ID family

Community Memorial Hospital Incorporated16 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.

• CMH Mountain Primary Care Clinic

  • Non-Pharmacy Dispensing Site
  • Mountain, WI
  • NPI 1407801236
  NPD tax ID
• CMH Primary Care Clinic Moutain-Physician Dispensary

  • Family Medicine Physician
  • Mountain, WI
  • NPI 1962533455
  NPD tax ID
• Community Memorial Hospital

  • Non-Pharmacy Dispensing Site
  • Mountain, WI
  • NPI 1144550880
  NPD tax ID
• Community Memorial Hospital

  • Non-Pharmacy Dispensing Site
  • Suring, WI
  • NPI 1316277056
  NPD tax ID
• Community Memorial Hospital

  • Clinical Social Worker
  • Oconto Falls, WI
  • NPI 1629302831
  NPD tax ID
• Community Memorial Hospital, Incorporated

  • Surgery Physician
  • Oconto Falls, WI
  • NPI 1386925915
  NPD tax ID
• Community Memorial Hospital, Incorporated

  • Physical Therapist
  • Oconto, WI
  • NPI 1437470572
  NPD tax ID
• St Clare Memorial Hospital, Inc

  • Physical Therapist
  • Oconto Falls, WI
  • NPI 1144541285
  NPD tax ID
• St Clare Memorial Hospital, Inc

  • Physical Therapist
  • Gillett, WI
  • NPI 1700107844
  NPD tax ID
• St Clare Memorial Hospital, Inc

  • Clinical Medical Laboratory
  • Oconto Falls, WI
  • NPI 1780851501
  NPD tax ID
• St Clare Memorial Hospital, Inc.

  • Institutional Pharmacy
  • Oconto Falls, WI
  • NPI 1073536967
  NPD tax ID
• St. Clare Memorial Hospital Inc.

  • Obstetrics & Gynecology Physician
  • Marinette, WI
  • NPI 1508224510
  NPD tax ID

• CMH Primary Care Clinic, Remote Dispensing Registration Other name

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Mar 7, 2023.

{
    "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"
        }
    ]
}

• Natasha Maire Bubolz, LPN
• Tori Lynn Bushmaker, OTR/L, MOT
• Jessica C Carriveau, PT
• Brianna Cibulka
• Jennifer Marie Clements, PTA
• Cooperative Educational Service Agency No 8
• Steven P Drake, OD
• Gillett Area Ambulance Service Inc.
• Gillett Dental Care, S.C.
• Gillett School District

• All providers in Gillett, WI
• Non-Pharmacy Dispensing Site in Wisconsin

• 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.