NPIMap

Organization Active NPI

St Nicholas Hospital of the Hospital Sisters of St Francis

Doing business as Prevea Health Employer Services

  • Family Medicine Physician
  • Sheboygan, WI
National Provider Identifier
1891130472
Registry record updated Dec 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
ST NICHOLAS HOSPITAL OF THE HOSPITAL SISTERS OF ST FRANCIS
Doing business as
Prevea Health Employer Services
Practice address
1020 S Taylor Dr
Sheboygan, WI 53081-4773
Phone
(920) 496-4700
NPI assigned
May 8, 2013
Last updated
Dec 22, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
ST NICHOLAS HOSPITAL -SISTERS OF THIRD ORDER OF ST FRANCISAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 22, 2021

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

Authorized official

Name
Andrew J Bagnall
Title
President and Ceo
Phone
(920) 496-4700

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X
Family Medicine Physician 207Q00000X Primary

Addresses

Primary practice location

1020 S Taylor Dr
Sheboygan, WI 53081-4773

Mailing address

PO Box 19059
Green Bay, WI 54307-9059
Phone (920) 496-4700

Other names 1

  • Prevea Health Employer Services Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address prevea_transitions_of_care2201213@ewd.direct.hshs.org Direct

National Provider Directory

National Provider Directory
Tax ID family
St Nicholas Hosp Physic8 organizations share this tax ID, including this one
Part of
St Nicholas Hosp Physic

Other organizations with this tax ID 7

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

Locations

1020 S Taylor Dr
Sheboygan, WI 53081
Phone (920) 452-5437

NPI Registry JSON

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

{
    "created_epoch": "1367971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1640131200000",
    "number": "1891130472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19059",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543079059",
            "telephone_number": "920-496-4700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 S TAYLOR DR",
            "city": "SHEBOYGAN",
            "state": "WI",
            "postal_code": "530814773",
            "telephone_number": "920-496-4700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST NICHOLAS HOSPITAL OF THE HOSPITAL SISTERS OF ST FRANCIS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ST NICHOLAS HOSPITAL -SISTERS OF THIRD ORDER OF ST FRANCIS",
        "enumeration_date": "2013-05-08",
        "last_updated": "2021-12-22",
        "certification_date": "2021-12-22",
        "status": "A",
        "authorized_official_last_name": "BAGNALL",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT AND CEO",
        "authorized_official_telephone_number": "920-496-4700"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "prevea_transitions_of_care2201213@ewd.direct.hshs.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "1020 S Taylor Dr",
            "city": "Sheboygan",
            "state": "WI",
            "country_code": "US",
            "postal_code": "530814773",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Prevea Health Employer Services",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Prevea Health Employer Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sheboygan, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2021; 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.