NPIMap

Organization Active NPI

Thedacare Medical Center Berlin

  • Rural Acute Care Hospital
  • Berlin, WI
National Provider Identifier
1477901833
Registry record updated May 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Acute Care HospitalTaxonomy code 282NR1301X
License
2461-19 Issued in WI
Legal business name
THEDACARE MEDICAL CENTER BERLIN
Practice address
225 Memorial Dr
Berlin, WI 54923-1243
Phone
(920) 361-5534
Fax
(920) 361-5910
NPI assigned
May 26, 2016
Last updated
May 26, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 26, 2016

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

Authorized official

Name
Dale Burkhouse, ATC
Title
Rehabilitation Director
Phone
(920) 361-5559

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Acute Care Hospital 282NR1301X 2461-19 WI Primary

Addresses

Primary practice location

225 Memorial Dr
Berlin, WI 54923-1243

Mailing address

225 Memorial Dr
Berlin, WI 54923-1243
Phone (920) 361-5534

Other names 1

  • Community Health Network Former legal business name

National Provider Directory

National Provider Directory
Tax ID family
CHN Princeton Family Me12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

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

NPI Registry JSON

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

{
    "created_epoch": "1464220800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1464220800000",
    "number": "1477901833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 MEMORIAL DR",
            "city": "BERLIN",
            "state": "WI",
            "postal_code": "549231243",
            "telephone_number": "920-361-5534",
            "fax_number": "920-361-5910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 MEMORIAL DR",
            "city": "BERLIN",
            "state": "WI",
            "postal_code": "549231243",
            "telephone_number": "920-361-5534",
            "fax_number": "920-361-5910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THEDACARE MEDICAL CENTER BERLIN",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-26",
        "last_updated": "2016-05-26",
        "status": "A",
        "authorized_official_last_name": "BURKHOUSE",
        "authorized_official_first_name": "DALE",
        "authorized_official_title_or_position": "REHABILITATION DIRECTOR",
        "authorized_official_telephone_number": "920-361-5559",
        "authorized_official_credential": "ATC"
    },
    "taxonomies": [
        {
            "code": "282NR1301X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Rural",
            "state": "WI",
            "license": "2461-19",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Community Health Network",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Berlin, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2016; 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.