NPIMap

Organization Active NPI

Agnesian Healthcare

  • Durable Medical Equipment & Medical Supplies
  • Randolph, WI
National Provider Identifier
1770529828
Registry record updated Nov 26, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
AGNESIAN HEALTHCARE
Practice address
137 Cambria St
Randolph, WI 53956
Phone
(920) 926-5303
NPI assigned
Jun 20, 2006
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Steven N Little
Title
SVP & Cfo
Phone
(920) 926-5402

Corporate family (same tax ID) 26

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

View all 26

National Provider Directory

National Provider Directory
Tax ID family
Fond Du Lac Regional CL (27 organizations share this tax ID)

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X Primary

Addresses

NPPES NPI Registry

Primary practice location

137 Cambria St
Randolph, WI 53956

Mailing address

420 E Division St
Fond Du Lac, WI 54935-4560
Phone (920) 926-8340

Other names 1

NPPES NPI Registry
  • FOND DU LAC REGIONAL CLINIC Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Nov 26, 2007.

{
    "created_epoch": "1150761600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196035200000",
    "number": "1770529828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 E DIVISION ST",
            "city": "FOND DU LAC",
            "state": "WI",
            "postal_code": "549354560",
            "telephone_number": "920-926-8340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "137 CAMBRIA ST",
            "city": "RANDOLPH",
            "state": "WI",
            "postal_code": "53956",
            "telephone_number": "920-926-5303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AGNESIAN HEALTHCARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-20",
        "last_updated": "2007-11-26",
        "status": "A",
        "authorized_official_last_name": "LITTLE",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "SVP & CFO",
        "authorized_official_telephone_number": "920-926-5402"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FOND DU LAC REGIONAL CLINIC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Randolph, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2007; 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.