Thedacare Medical Center - New London, Inc

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

Legal business name

THEDACARE MEDICAL CENTER - NEW LONDON, INC

Practice address

1405 Mill Street
New London, WI 54961-0307

Phone

(920) 531-2021

Fax

(920) 531-2029

NPI assigned

Aug 11, 2006

Last updated

Jan 3, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. William Flett

Title

Cfo

Phone

(920) 454-4013

Specialties & licenses 1

Addresses

Other names 1

• part B physicians Other name

Tax ID family

New London Family Med Ctr5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

• New London Family Medical Center Inc

  dba New London Family Medical Center

  • Non-Pharmacy Dispensing Site
  • New London, WI
  • NPI 1972928463
  NPD tax ID
• Thedacare Medical Center - New London, Inc

  • Ambulance
  • New London, WI
  • NPI 1992848790
  NPD tax ID
• Thedacare Medical Center - New London, Inc.

  • Anesthesiology Physician
  • New London, WI
  • NPI 1073611083
  NPD tax ID
• Thedacare Medical Center - New London, Inc.

  • Clinical Medical Laboratory
  • New London, WI
  • NPI 1386875466
  NPD tax ID

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

{
    "created_epoch": "1155254400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704240000000",
    "number": "1811908858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 NEENAH CTR",
            "city": "NEENAH",
            "state": "WI",
            "postal_code": "549563070",
            "telephone_number": "920-830-8900",
            "fax_number": "920-830-5910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1405 MILL STREET",
            "city": "NEW LONDON",
            "state": "WI",
            "postal_code": "549610307",
            "telephone_number": "920-531-2021",
            "fax_number": "920-531-2029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THEDACARE MEDICAL CENTER - NEW LONDON, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-11",
        "last_updated": "2024-01-03",
        "certification_date": "2024-01-03",
        "status": "A",
        "authorized_official_last_name": "FLETT",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "920-454-4013",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "part B physicians",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "part B physicians",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Craig E Sylte, O.D.
• Mark Alan Tegtmeier, MA, LCSW, LPC, LMFT
• Marcella K Teske, APNP
• The Pharmacy of New London Inc. (Jernegan's Health Mart Pharmacy)
• Thedacare Medical Center - New London, Inc
• Thedacare Medical Center - New London, Inc
• Thedacare Medical Center - New London, Inc.
• Thedacare Medical Center - New London, Inc.
• Thedacare Medical Center - New London, Inc.
• Thedacare, Incorporated (ThedaCare Physicians)

• Emergency Medicine Physician in New London, WI
• Providers in New London, WI by specialty
• Emergency Medicine Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2024; 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.