NPIMap

Organization Active NPI

Agnesian Healthcare Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Fond Du Lac, WI
National Provider Identifier
1760902191
Registry record updated Jan 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
License
2226 Issued in WI
Legal business name
AGNESIAN HEALTHCARE INC
Practice address
371 E 1St St
Fond Du Lac, WI 54935-4563
Phone
(920) 907-3967
NPI assigned
Jun 27, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2025

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

Authorized official

Name
Joseph R Minerath
Title
System Director - Gov'T Reimb.
Phone
(608) 445-2411

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X 2226 WI Primary

Addresses

Primary practice location

371 E 1St St
Fond Du Lac, WI 54935-4563

Mailing address

40 Camelot Dr
Fond Du Lac, WI 54935-8049
Phone (920) 907-8201

Other names 1

  • SSM Health Treffert Center Autism Services Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Fond Du Lac Regional CL27 organizations share this tax ID, including this one

Other organizations with this tax ID 26

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

View all 26

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1498521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1738195200000",
    "number": "1760902191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 CAMELOT DR",
            "city": "FOND DU LAC",
            "state": "WI",
            "postal_code": "549358049",
            "telephone_number": "920-907-8201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "371 E 1ST ST",
            "city": "FOND DU LAC",
            "state": "WI",
            "postal_code": "549354563",
            "telephone_number": "920-907-3967"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AGNESIAN HEALTHCARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-27",
        "last_updated": "2025-01-30",
        "certification_date": "2025-01-30",
        "status": "A",
        "authorized_official_last_name": "MINERATH",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "SYSTEM DIRECTOR - GOV'T REIMB.",
        "authorized_official_telephone_number": "608-445-2411"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "WI",
            "license": "2226",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SSM Health Treffert Center Autism Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fond Du Lac, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2025; 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.