Thedacare, Incorporated
Organization Active NPI Home Infusion Therapy Pharmacy · Appleton, WI
NPI 1699861617 · NPPES record last updated Jan 2, 2024
Key facts
- NPI
- 1699861617
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Home Infusion Therapy Pharmacy 3336H0001X
- License
- 7196-042 (WI)
- Legal business name
- THEDACARE, INCORPORATED
- Practice address
- 1818 N Meade St
Appleton, WI 54911-3454 - Phone
- (920) 969-0919
- Fax
- (920) 730-3433
- NPI assigned
- Oct 5, 2006
- Organization subpart
- No
Authorized official
- Name
- William Flett
- Title
- Cfo
- Phone
- (920) 454-4013
Owned or controlled facilities with NPI records 30
Other NPIs with the same Medicare PAC ID 11
Corporate family (same tax ID) 19
Practitioners 654
-
Mohamed Hassan Abdelazim, APNP
-
Laura Adams-Burkley, LCSW, CADC
-
Syed M Ala, MD
-
Catherine A Allen, MSN, APNP
-
Angela Kaye Amos, MD
-
David Anderla, MD
-
Jennifer Ashley Anderson, DNP, FNP-C
-
Matthew S Anderson, M.D.
-
Ashley J Andrus, APNP
-
Michelle A Angsten, LPC-T
-
Trevor D Argall, MD, MS
-
Omar Atassi, M.D.
-
Becky Aus, FNP-C
-
Rachell Renae Ayers, M.D.
Laboratory certificates & supplier records
Medicare medical equipment & supply locations
| Supplier | Supplies | Medicare assignment |
|---|---|---|
| Thedacare, Incorporated |
Immunosuppressive Drugs|Infusion Drugs|Nebulizer Drugs|External Infusion Pumps and/or Supplies|Parenteral Nutrients|Parenteral Equipment and/or Supplies | Accepts assignment |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
All facility ownership & control disclosures 15
| Facility | Type | Role | Since |
|---|---|---|---|
| Thedacare Medical Center - Berlin, Inc. |
Hospital | Operational/Managerial Control (100%) | Jun 30, 2014 |
| Thedacare Medical Center - Wild Rose, Inc. |
Hospital | Operational/Managerial Control | Jul 1, 2014 |
| Thedacare Medical Center - Wild Rose, Inc. |
Hospital | Operational/Managerial Control | Jul 1, 2014 |
| Thedacare Medical Center - Shawano, Inc. |
Hospital | Operational/Managerial Control | Jan 30, 2011 |
| Thedacare Medical Center - Shawano, Inc. |
Hospital | Operational/Managerial Control | Jan 30, 2011 |
| Thedacare Regional Medical Center-Neenah Inc |
Hospital | Operational/Managerial Control | Jan 19, 2011 |
| Thedacare Regional Medical Center - Appleton, Inc |
Hospital | Operational/Managerial Control | Nov 22, 2010 |
| Thedacare Medical Center - Waupaca, Inc |
Hospital | Operational/Managerial Control | Jun 1, 2006 |
| Thedacare Medical Center - Waupaca, Inc |
Hospital | Operational/Managerial Control | Jun 1, 2006 |
| Thedacare Medical Center - New London, Inc |
Hospital | Operational/Managerial Control | Jan 1, 2000 |
| Thedacare Medical Center - New London, Inc |
Hospital | Operational/Managerial Control | Jan 1, 2000 |
| Thedacare Regional Medical Center - Appleton, Inc |
Hospital | Operational/Managerial Control | Jan 1, 2024 |
| Juliette Manor |
Skilled nursing facility | Operational/Managerial Control (100%) | Jun 30, 2014 |
| Thedacare Medical Center - Shawano, Inc. |
Rural health clinic | Operational/Managerial Control | Jan 19, 2011 |
| Shawano Medical Center Inc |
Rural health clinic | Operational/Managerial Control | Jan 19, 2011 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100930066042 | WI | DME Supplier - Pharmacy | 1759294887 | Practice locations: Appleton, WI |
National Provider Directory
- Tax ID family
- Novus Laboratories
Locations
3000 E College Ave
#A
Appleton, WI 54915
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Infusion Therapy Pharmacy | 3336H0001X | 7196-042 | WI | Yes |
Addresses
Primary practice location
1818 N Meade St
Appleton, WI 54911-3454
Mailing address
3 Neenah Ctr
Neenah, WI 54956-3070
Phone (920) 454-4229
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 33228200 | Medicaid | WI |
Other names
- ThedaCare At Home Infusion Pharmacy
Other providers in Appleton, WI
- Thedacare, Incorporated
- Thedacare, Incorporated
- Thedacare, Incorporated
- Thedacare, Incorporated
- Thedacare, Incorporated
- Thedacare, Incorporated
- Thedacare, Incorporated
- Joseph E Theisen
- Therapy Time for K.I.D.S.
- Adrian Chaya Theriot
All providers in Appleton, WI · Home Infusion Therapy Pharmacy in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 2, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.