NPIMap

Organization Active NPI

County of Brown

Doing business as Brown County Community Treatment Center-Nicolet Psych

  • Psychiatric Hospital
  • Green Bay, WI
National Provider Identifier
1801908975
Registry record updated May 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric HospitalTaxonomy code 283Q00000X
License
213 Issued in WI
Legal business name
COUNTY OF BROWN
Doing business as
Brown County Community Treatment Center-Nicolet Psych
Practice address
3150 Gershwin Drive
Green Bay, WI 54311-5859
Phone
(920) 391-4700
Fax
(920) 391-4870
NPI assigned
Aug 31, 2006
Last updated
May 10, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
COUNTY OF BROWNAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 10, 2024

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

Authorized official

Name
Kara Gruber
Title
Administrator
Phone
(920) 391-4700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Hospital 283Q00000X 213 WI Primary

Addresses

Primary practice location

3150 Gershwin Drive
Green Bay, WI 54311-5859

Mailing address

3150 Gershwin Drive
Green Bay, WI 54311-5859
Phone (920) 391-4700

Other names 1

  • Brown County Community Treatment Center-Nicolet Psych Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100325000037 WI Part A Provider - Hospital 1355435900 Practice locations: Green Bay, WI
O20100524000844 WI Part B Supplier - Clinic/Group Practice 1355435900 Receives reassigned benefits from 22 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Green Bay, WI

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1801908975. Details of each certification follow.

Hospital certification: CCN 524014

Legal name
COUNTY OF BROWN
Doing business as
COMMUNITY TREATMENT CENTER
Certification status
Active
Provider type (POS)
Hospital – Psychiatric
Participating since
Nov 5, 1969
Last certification
Apr 19, 2023
Beds
88
Ownership / control type
Local
Organization structure
GovernmentProprietary
Enrollment address
3150 Gershwin Dr
Green Bay, WI 54311-4328
Hospital Psychiatric Unit
Hospital subgroups
Psychiatric, Psychiatric unit

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

  • County of Brown

    dba Brown County Community Treatment Center-Bayshore Village

    • Skilled Nursing Facility
    • Green Bay, WI
    • NPI 1033214150

    1355435900

    Same PAC ID
  • County of Brown

    dba Brown County Community Treatment Center - Clinic

    • Mental Health Clinic/Center (Including Community Mental Health Center)
    • Green Bay, WI
    • NPI 1942305065

    1355435900

    Same PAC ID

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

  • County of Brown

    dba Brown County Community Treatment Center - MD Group

    • Psychiatry Physician
    • Green Bay, WI
    • NPI 1679747059

    O20100524000844

    Same enrollment
  • County of Brown

    dba Brown County Community Treatment Center - Clinic

    • Mental Health Clinic/Center (Including Community Mental Health Center)
    • Green Bay, WI
    • NPI 1942305065

    O20100524000844

    Same enrollment

Care Compare: Hospital

Medicare Care Compare
Listed as
Brown County Community Treatment CtrCCN 524014 · All quality measures
Type
Psychiatric
Ownership
Government - Local
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
No

National Provider Directory

National Provider Directory
Tax ID family
Brown County Health Dep19 organizations share this tax ID, including this one
Part of
Brown County Health Dep

Other organizations with this tax ID 18

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

View all 18

Ownership & related parties

All disclosed owners & managing parties 3

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
County of Brown Organization, Green Bay, WI Operational/Managerial Control Jan 1, 2010
Kara Gruber Individual Corporate DirectorHospital Administrator Jun 6, 2022
Operational/Managerial ControlHospital Administrator Jun 6, 2022
Erik J Pritzl Individual Corporate DirectorHumans Service Executive Directo Apr 1, 2015
Operational/Managerial ControlHuman Services Executive Directo Apr 1, 2015

Owners & managing parties with NPI records 2

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

  • County of Brown

    dba Brown County Community Treatment Center-Bayshore Village

    • Skilled Nursing Facility
    • Green Bay, WI
    • NPI 1033214150

    Operational/Managerial Control

    CMS ownership
  • County of Brown

    dba Brown County Community Treatment Center - Clinic

    • Mental Health Clinic/Center (Including Community Mental Health Center)
    • Green Bay, WI
    • NPI 1942305065

    Operational/Managerial Control

    CMS ownership

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Brown County Community Treatment Center - Bayshore VillageGreen Bay, WI, CCN 525693 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Adp of the SNF		 Oct 10, 2009
Oct 10, 2009

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

  • County of Brown

    dba Brown County Community Treatment Center-Bayshore Village

    • Skilled Nursing Facility
    • Green Bay, WI
    • NPI 1033214150

    5% Or Greater Direct Ownership Interest, Adp of the SNF

    CMS ownership

Facilities with the same owner 1

Facilities that share an organizational owner with 5% or greater ownership or operational control.

  • County of Brown

    dba Brown County Community Treatment Center-Bayshore Village

    • Skilled Nursing Facility
    • Green Bay, WI
    • NPI 1033214150

    County of Brown

    CMS ownership

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715299200000",
    "number": "1801908975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3150 GERSHWIN DRIVE",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543115859",
            "telephone_number": "920-391-4700",
            "fax_number": "920-391-4870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3150 GERSHWIN DRIVE",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543115859",
            "telephone_number": "920-391-4700",
            "fax_number": "920-391-4870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTY OF BROWN",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COUNTY OF BROWN",
        "enumeration_date": "2006-08-31",
        "last_updated": "2024-05-10",
        "certification_date": "2024-05-10",
        "status": "A",
        "authorized_official_last_name": "GRUBER",
        "authorized_official_first_name": "KARA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "920-391-4700"
    },
    "taxonomies": [
        {
            "code": "283Q00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Hospital",
            "state": "WI",
            "license": "213",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Brown County Community Treatment Center-Nicolet Psych",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Green Bay, WI

Sources for this page

Verify at the official NPI Registry.