NPIMap

Organization Active NPI

Thedacare Regional Medical Center - Neenah, Inc

  • Non-Pharmacy Dispensing Site
  • Neenah, WI
National Provider Identifier
1407271992
Registry record updated Jan 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-Pharmacy Dispensing SiteTaxonomy code 332900000X
Legal business name
THEDACARE REGIONAL MEDICAL CENTER - NEENAH, INC
Practice address
130 2ND St
Neenah, WI 54956-2883
Phone
(920) 729-3100
NPI assigned
Feb 20, 2014
Last updated
Jan 2, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
THEDA CLARK MEDICAL CENTER INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 2, 2024

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

Authorized official

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

Specialties & licenses 1

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

Addresses

Primary practice location

130 2ND St
Neenah, WI 54956-2883

Mailing address

6501 City West Pkwy
Eden Prairie, MN 55344-3248
Phone (952) 653-2525

Other names 1

  • Theda Clark Medical Center, INC Former legal business name

National Provider Directory

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

Other organizations with this tax ID 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1392854400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704153600000",
    "number": "1407271992",
    "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",
            "telephone_number": "952-653-2525"
        },
        {
            "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": "920-729-3100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THEDACARE REGIONAL MEDICAL CENTER - NEENAH, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "THEDA CLARK MEDICAL CENTER INC.",
        "enumeration_date": "2014-02-20",
        "last_updated": "2024-01-02",
        "certification_date": "2024-01-02",
        "status": "A",
        "authorized_official_last_name": "FLETT",
        "authorized_official_first_name": "WLLIAM",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "920-454-4013"
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Theda Clark Medical Center, INC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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 Jan 2, 2024; 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.