St. Vincent Hospital-Hospital Sisters-Third Order of St Francis
Organization Active NPI Hematology & Oncology Physician · Sheboygan, WI
NPI 1831784636 · NPPES record last updated Dec 23, 2021
Key facts
- NPI
- 1831784636
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Hematology & Oncology Physician 207RH0003X
- Legal business name
- ST. VINCENT HOSPITAL-HOSPITAL SISTERS-THIRD ORDER OF ST FRANCIS
- Practice address
- 1621 N Taylor Dr Ste 300
Sheboygan, WI 53081-1992 - Phone
- (920) 884-3135
- NPI assigned
- Mar 3, 2021
- Organization subpart
- Yes
- Parent organization (as reported)
- ST VINCENT HOSPITAL-HOSPITAL SISTERS-THIRD ORDER OF ST FRANCIS
Authorized official
- Name
- Ms. Patricia Allen
- Title
- Cfo
- Phone
- (920) 884-5660
Owners & managing parties with NPI records 2
-
Stephanie Lynn Bakey, D.O.
-
Kyle James McCarty, M.D.
Other NPIs on the same Medicare enrollment 4
Related certifications (CCN) 1
Affiliated clinicians 573
-
Humera Fatima Ahmad, M.D.
-
Osaid K Ahmad, MD
-
Yousaf Ajam, MD
-
Zaheer Akhtar, DO
-
Adebisi O Alimi, M.D.
-
Laura Alsteen, APNP
-
Lucas Scott Altman, FNP
-
Richard Amankwah, MD
-
Kristin A. Anderson-Cronin, PMHNP-BC
-
Angela Anderson, NP
-
Lacey Renee Anderson, CRNA
-
Sara Lynn Anderson, M.D.
-
Keisha Lynn Apps, APRN
Medicare Care Compare: Hospital
- Listed as
- St Vincent Hospital
- Overall star rating
- ★★★★☆ 4 of 5
- Type
- Acute Care Hospitals
- Ownership
- Voluntary non-profit - Church
- Medicare certification status
- Active
- Emergency services
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
Hospital certification: CCN 520075
- Legal name
- ST VINCENT HOSPITAL-HOSPITAL SISTERS-THIRD ORDER OF ST FRANCIS
- Doing business as
- ST. VINCENT HOSPITAL
- Certification status
- Active
- Provider type (POS)
- Hospital – Short-term
- Participating since
- Jul 1, 1966
- Last certification
- Sep 22, 2003
- Beds
- 523
- Ownership / control type
- Church
- Organization structure
- Corporation · Non-profit
- Enrollment address
- 835 S Van Buren St
Green Bay, WI 54301-3526 - Hospital subgroups
- General, Acute care
All disclosed owners & managing parties 16
| Name | Role | Since | Share |
|---|---|---|---|
| Hospital Sisters Health System Inc |
5% Or Greater Direct Ownership Interest | Oct 20, 2014 | 100% |
| Dennis Langenberg |
Corporate Director | Nov 1, 2018 | |
| Stephanie L Bakey |
Corporate Director |
Nov 1, 2021 | |
| Paula Hafeman |
Corporate Director |
Nov 1, 2021 | |
| Marcus Perez |
Corporate Director |
Nov 1, 2022 | |
| Patricia L Allen |
Corporate Officer |
Jan 1, 2020 | |
| Corporate Director |
Jan 1, 2020 | ||
| Maureen Fagan |
Corporate Director | Nov 1, 2018 | |
| Jody Anne Boes |
Corporate Director |
Nov 1, 2021 | |
| Hospital Sisters Services Inc |
5% Or Greater Indirect Ownership Interest | Oct 20, 2014 | 100% |
| Kyle J McCarty |
Corporate Director |
Nov 1, 2022 | |
| Nicole Schneider |
Corporate Director |
Nov 1, 2020 | |
| John Wagner |
Corporate Officer |
Oct 15, 2022 | |
| Corporate Director |
Oct 15, 2022 | ||
| Damond Williams Boatwright |
Corporate Officer |
Jul 19, 2021 | |
| Michael Wickman |
Corporate Officer | Nov 1, 2018 | |
| Robert Erickson |
Corporate Officer |
Apr 29, 2024 | |
| Corporate Director |
Apr 29, 2024 | ||
| W-2 Managing Employee |
Apr 29, 2024 | ||
| Travis Pitzen |
Corporate Officer |
Sep 30, 2024 | |
| Corporate Director |
Sep 30, 2024 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20030421000001 | WI | Part a Provider - Hospital | 5799694675 |
4 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Sturgeon Bay, WI; Sheboygan, WI; Green Bay, WI; Oconto Falls, WI |
National Provider Directory
- Part of
- St Vincent Hospital-Hospita
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Hematology & Oncology Physician |
207RH0003X | Yes |
Addresses
Primary practice location
1621 N Taylor Dr Ste 300
Sheboygan, WI 53081-1992
Mailing address
PO Box 271369
Salt Lake City, UT 84127-1369
Phone (920) 884-3135
Other names
- St. Vincent Regional Cancer Center
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | stvincent_stmary_stnicholas_stclare@ewd.direct.hshs.org | Direct |
Other providers in Sheboygan, WI
- St. Nicholas Hospital-Sisters of the Third Order of St Francis
- St. Nicholas Hospital-Sisters of the Third Order of St. Francis
- St. Nicholas Hospital-Sisters of the Third Order of St. Francis
- St. Nicholas Hospital-Sisters of the Third Order of St. Francis
- St. Nicholas Hospital-Sisters of the Third Order of St. Francis
- St. Vincent Hospital-Hospital Sisters-Third Order of St. Francis
- Taylor R Stamm
- Luke Elliot Stanczyk
- Natalie Stanczyk
- Jane M Stark
All providers in Sheboygan, WI · Hematology & Oncology Physician in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 23, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.