NPIMap

Organization Active NPI

Door County Memorial Hospital

  • Clinical Medical Laboratory
  • Sturgeon Bay, WI
National Provider Identifier
1811090285
Registry record updated Apr 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
DOOR COUNTY MEMORIAL HOSPITAL
Practice address
323 S 18TH Ave
Sturgeon Bay, WI 54235-1401
Phone
(920) 743-5566
NPI assigned
Sep 7, 2006
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Mr. Andrew S Laluzerne
Title
Cfo
Phone
(920) 746-3729

Owners & managing parties with NPI records 19

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

View all 19

Other NPIs on the same Medicare enrollment 1

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

Practitioners 1

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

Affiliated clinicians 312

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 312

Care Compare: Hospital

Medicare Care Compare
Listed as
Door County Medical CenterCCN 521358
Overall star rating
4 of 5
Type
Critical Access Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
52D0394804Door County Memorial Hospital323 S 18TH Avenue, Sturgeon Bay, WI 54235AccreditationMar 14, 2027
52D1098274Door County Medical Center-Sturgeon Bay Clinic323 S 18TH Ave, Sturgeon Bay, WI 54235Certificate of waiverApr 14, 2027
52D2076425Prevea - Door County Occupational Health323 S 18TH Street, Sturgeon Bay, WI 54235Certificate of waiverApr 17, 2028
52D2190884Door County Memorial Hospital323 S 18TH Ave, Sturgeon Bay, WI 54235Certificate of waiverAug 19, 2026

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20061104000697 WI Part A Provider - Critical Access Hospital 5395735088 Receives reassigned benefits from 90 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Sturgeon Bay, WI; Algoma, WI; Sister Bay, WI

Hospital certification: CCN 521358

Legal name
DOOR COUNTY MEMORIAL HOSPITAL
Doing business as
DOOR COUNTY MEDICAL CENTER
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Jun 13, 2006
Last certification
Jul 14, 2022
Beds
25
Ownership / control type
Private (not for profit)
Organization structure
OtherNon-profit
Incorporated
Oct 16, 1944 in WI
Enrollment address
323S 18TH Ave
Sturgeon Bay, WI 54235-1401

Facilities connected through Provider of Services related, parent or unit certification numbers.

All disclosed owners & managing parties 20

Medicare enrollment files

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

NameRoleSinceShare
Edgar K Collison Individual Corporate DirectorBoard Member May 14, 2025
Patricia M Vickman Individual Corporate DirectorBoard Member Oct 1, 2017
Pauline M Helm Individual Corporate DirectorBoard Member Jan 1, 2023
Andrew S Laluzerne Individual Corporate OfficerCfo Oct 29, 2018
Joseph Joshua Rebhan Individual Corporate DirectorBoard Member Jan 1, 2026
Martha S Ziegelbauer Individual Corporate DirectorBoard Member Jan 1, 2022
Michael R St Jean Individual Corporate DirectorBoard Member Jan 1, 2025
Jamie D Alberts Individual Corporate DirectorBoard Member Jan 1, 2021
Tammy a Sternard Individual Corporate DirectorBoard Member Jan 1, 2025
Joel C Kitchens Individual Corporate DirectorBoard Member Jan 1, 2021
St Vincent Hospital-Hospital Sisters-Third Order of St Francis Organization, Green Bay, WI Corporation, Non-profit Operational/Managerial Control Nov 1, 2016 40%
Erin Rae Helgeson Individual Corporate DirectorBoard Member Jan 1, 2024
Dorene E Dempster Individual Corporate DirectorBoard Member/ Medical Staff Preside Jan 1, 2019
Bradley S Andreae Individual Corporate DirectorBoard Member Jan 1, 2024
Jeffrey J Rabas Individual Corporate DirectorBoard Member Jan 1, 2022
Jonathan L Jarosh Individual Corporate DirectorBoard Member Jan 1, 2024
Robert Erickson Individual Corporate DirectorBoard Member May 15, 2024
Brian C Stephens Individual Corporate OfficerCeo Jan 6, 2019
Operational/Managerial ControlCeo Jan 6, 2019
Corwin D Dahl Individual Corporate DirectorBoard Member Jan 1, 2021
Andrew Richmond Individual Corporate DirectorBoard Member Oct 1, 2017

National Provider Directory

National Provider Directory
Tax ID family
Door Cnty Mem HSP16 organizations share this tax ID, including this one

Other organizations with this tax ID 15

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

View all 15

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X WI Primary

Addresses

NPPES NPI Registry

Primary practice location

323 S 18TH Ave
Sturgeon Bay, WI 54235-1401

Mailing address

323 S 18TH Ave
Sturgeon Bay, WI 54235-1401
Phone (920) 743-5566

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
32946100MedicaidWI

Other names 1

NPPES NPI Registry
  • Door County Medical Center Lab 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 Apr 6, 2022.

{
    "created_epoch": "1157587200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1649203200000",
    "number": "1811090285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "323 S 18TH AVE",
            "city": "STURGEON BAY",
            "state": "WI",
            "postal_code": "542351401",
            "telephone_number": "920-743-5566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "323 S 18TH AVE",
            "city": "STURGEON BAY",
            "state": "WI",
            "postal_code": "542351401",
            "telephone_number": "920-743-5566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOOR COUNTY MEMORIAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-07",
        "last_updated": "2022-04-06",
        "certification_date": "2022-04-06",
        "status": "A",
        "authorized_official_last_name": "LALUZERNE",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "920-746-3729",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "WI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32946100",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Door County Medical Center Lab",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sturgeon Bay, WI

Sources for this page

Verify at the official NPI Registry.