Thedacare Regional Medical Center - Appleton, Inc
Organization Active NPI General Acute Care Hospital · Appleton, WI
NPI 1740920909 · NPPES record last updated Nov 14, 2024
Key facts
- NPI
- 1740920909
- Entity type
- Organization (NPI type 2)
- Primary specialty
- General Acute Care Hospital 282N00000X
- Legal business name
- THEDACARE REGIONAL MEDICAL CENTER - APPLETON, INC
- Practice address
- 2400 E Capitol Drive
Appleton, WI 54911-8728 - Phone
- (920) 731-4101
- Fax
- (920) 738-6319
- NPI assigned
- Mar 29, 2022
- Organization subpart
- No
Authorized official
- Name
- Mr. William Flett
- Title
- Cfo
- Phone
- (920) 454-4013
Owners & managing parties with NPI records 14
-
David W Koeper, MD
Other NPIs on the same Medicare enrollment 6
Corporate family (same tax ID) 11
Related certifications (CCN) 1
Affiliated clinicians 827
-
Julie Ann Abboud, D.P.M.
-
Mohamed Hassan Abdelazim, APNP
-
Sameem M Abedin, MD
-
Mark G Adorjan, MD
-
Sara J Aerts, NP
-
Suraiya Afroz, D.O.
-
Osaid K Ahmad, MD
-
Catherine A Allen, MSN, APNP
-
Kristina Rae Almanza, APRN
-
Robert William Amorde, M.D.
-
David Anderla, MD
-
Jennifer Ashley Anderson, DNP, FNP-C
-
Laura Mae Anderson, APNP
-
Matthew S Anderson, M.D.
-
Ashley J Andrus, APNP
-
Christine Arendt, NP
Medicare Care Compare: Hospital
- Listed as
- Thedacare Regional Medical Center - Appleton Inc
- Overall star rating
- ★★★★☆ 4 of 5
- Type
- Acute Care Hospitals
- Ownership
- Voluntary non-profit - Private
- Medicare certification status
- Active
- Emergency services
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
Hospital certification: CCN 520160
- Legal name
- THEDACARE REGIONAL MEDICAL CENTER - APPLETON, INC
- Certification status
- Active
- Provider type (POS)
- Hospital – Short-term
- Participating since
- Jul 1, 1966
- Last certification
- Mar 13, 2013
- Beds
- 160
- Ownership / control type
- Private (not for profit)
- Organization structure
- Corporation · Non-profit
- Incorporated
- Feb 20, 1958 in WI
- Enrollment address
- 1818 N Meade St
Appleton, WI 54911-3454 - Hospital subgroups
- General
All disclosed owners & managing parties 14
| Name | Role | Since | Share |
|---|---|---|---|
| Froedtert Thedacare Health, Inc. |
Operational/Managerial Control | Jan 1, 2024 | |
| Jennifer R Glasheen |
W-2 Managing Employee |
Jan 1, 2023 | |
| Laurie a Carter |
Corporate Director |
Feb 1, 2022 | |
| Thedacare, Incorporated |
Operational/Managerial Control | Nov 22, 2010 | |
| Mary W Goggans |
Corporate Director |
Feb 1, 2022 | |
| Alan Loux |
Corporate Director |
Jan 1, 2023 | |
| William Flett |
Corporate Director |
Oct 31, 2023 | |
| W-2 Managing Employee | Oct 31, 2023 | ||
| Imran a Andrabi |
Corporate Director | Jun 28, 2017 | |
| Chuck Dallas |
Corporate Director |
Feb 11, 2021 | |
| David W Koeper |
Corporate Director |
Jan 1, 2023 | |
| Susan M Pahl |
W-2 Managing Employee |
Jan 1, 2023 | |
| Steven J Price |
Corporate Director |
Jan 1, 2024 | |
| Kathleen Pigeon |
W-2 Managing Employee |
Jun 11, 2000 | |
| Michael Morse |
Corporate Director |
Jan 1, 2024 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20101215000214 | WI | Part a Provider - Hospital | 2163319039 |
6 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Appleton, WI; Fond Du Lac, WI; Oshkosh, WI |
National Provider Directory
- Tax ID family
- Appleton Medical Center
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Acute Care Hospital | 282N00000X | Yes |
Addresses
Primary practice location
2400 E Capitol Drive
Appleton, WI 54911-8728
Mailing address
2400 E Capitol Drive
Appleton, WI 54911-8728
Phone (920) 731-4101
Other names
- ThedaCare Medical Center Orthopedics, Spine, and Pain
Other providers in Appleton, WI
- The Wellness Way Appleton
- Theda Care Peabody Manor
- Thedacare Aco, LLC
- Thedacare Inc
- Thedacare Regional Medical Center - Appleton Inc.
- Thedacare Regional Medical Center - Appleton, Inc
- Thedacare Regional Medical Center - Appleton, Inc.
- Thedacare Regional Medical Center - Appleton, Inc.
- Thedacare Regional Medical Center - Appleton, Inc.
- Thedacare Regional Medical Center - Appleton, Inc.
All providers in Appleton, WI · General Acute Care Hospital in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 14, 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.