St. Mary's Hospital

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

1193624 Issued in WI

Legal business name

ST. MARY'S HOSPITAL

Practice address

1726 Shawano Ave
Green Bay, WI 54303-3216

Phone

(920) 498-4267

NPI assigned

Oct 29, 2013

Last updated

Dec 22, 2021By 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

Therese B. Pandl

Title

President and Chief Executive Offic

Phone

(920) 884-5801

Specialties & licenses 1

Addresses

Electronic endpoints 1

Tax ID family

St Mary's Hospital Med Ctr2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• St Mary's Hospital Medical Center of Green Bay Inc.-Hospital Sisters

  dba St. Mary's Hospital Outpatient Lab

  • Clinical Medical Laboratory
  • Green Bay, WI
  • NPI 1043828387
  NPD tax ID

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

{
    "created_epoch": "1383004800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1640131200000",
    "number": "1619305703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1726 SHAWANO AVE",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543033216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1726 SHAWANO AVE",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543033216",
            "telephone_number": "920-498-4267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. MARY'S HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-29",
        "last_updated": "2021-12-22",
        "certification_date": "2021-12-22",
        "status": "A",
        "authorized_official_last_name": "PANDL",
        "authorized_official_first_name": "THERESE",
        "authorized_official_middle_name": "B.",
        "authorized_official_title_or_position": "PRESIDENT AND CHIEF EXECUTIVE OFFIC",
        "authorized_official_telephone_number": "920-884-5801"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "WI",
            "license": "1193624",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "stvincent_stmary_stnicholas_stclare@ewd.direct.hshs.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "1726 Shawano Ave",
            "city": "Green Bay",
            "state": "WI",
            "country_code": "US",
            "postal_code": "543033216",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• St Vincent Hospital-Hospital Sisters-Third Order of St Francis (St Vincent Hospital Rehabilitation Unit)
• St Vincent Hospital-Hospital Sisters-Third Order of St Francis (Prevea Health-St Vincent DME Supplier)
• St Vincent Hospital-Hospital Sisters-Third Order of St. Francis (Prevea Health)
• John J St. Andre, CCP
• St. Clare Memorial Hospital, Inc. (HSHS SCO Regional Surgery Center Green Bay)
• St. Mary's Hospital Medical Center of Green Bay Inc.-Hospital Sisters (St. Gianna Clinic)
• St. Vincent Hospital of the Hospital Sisters-Third Order of St. Franci (Prevea Health)
• St. Vincent Hospital-Hospital Sisters-Third Order of St Francis (Prevea Health)
• St. Vincent Hospital-Hospital Sisters-Third Order of St. Francis (St. Vincent Regional Cancer Center)
• St. Vincent Hospital-Hospital Sisters-Third Order of St. Francis (St. Vincent Hospital-Libertas of Green Bay)

• Physical Therapy Clinic/Center in Green Bay, WI
• Providers in Green Bay, WI by specialty
• Physical Therapy Clinic/Center in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2021; 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.