NPIMap

Organization Active NPI

Froedtert Health Neighborhood Hospital, LLC

Doing business as Froedtert Community Hospital

  • General Acute Care Hospital
  • Mequon, WI
National Provider Identifier
1902474430
Registry record updated Oct 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
Legal business name
FROEDTERT HEALTH NEIGHBORHOOD HOSPITAL, LLC
Doing business as
Froedtert Community Hospital
Practice address
11421 N PT Washington Rd
Mequon, WI 53092
Phone
(262) 518-4910
Fax
(262) 518-4911
NPI assigned
Jun 11, 2021
Last updated
Oct 3, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
FROEDTERT HEALTH NEIGHBORHOOD HOSPITAL, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 3, 2025

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

Authorized official

Name
Allen J Ericson
Title
President
Phone
(262) 836-8092

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X NU Primary

Addresses

Primary practice location

11421 N PT Washington Rd
Mequon, WI 53092

Mailing address

N74W12501 Leatherwood CT Ste 103
Menomonee Falls, WI 53051-4490
Phone (414) 777-0417

Other names 1

  • Froedtert Community Hospital Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200910002837 WI Part A Provider - Hospital 4587082318 3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Mequon, WI; New Berlin, WI; Oak Creek, WI; Pewaukee, WI

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1902474430. Details of each certification follow.

Hospital certification: CCN 520213

Legal name
FROEDTERT HEALTH NEIGHBORHOOD HOSPITAL, LLC
Doing business as
FROEDTERT COMMUNITY HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Dec 22, 2020
Last certification
Dec 22, 2020
Beds
16
Ownership / control type
Private (not for profit)
Organization structure
LLCNon-profit
Incorporated
Sep 24, 2019 in WI
Enrollment address
4805 S Moorland Rd
New Berlin, WI 53151-7401
Main/Primary Hospital Location
Hospital subgroups
General, Acute care

Other NPIs on the same Medicare enrollment 3

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Froedtert Community HospitalCCN 520213 · All quality measures
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory
Tax ID family
Froedtert Health Neighborhood Hospital LLC4 organizations share this tax ID, including this one
Part of
Froedtert Health Neighborhood Hospital LLC

Other organizations with this tax ID 3

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

Ownership & related parties

All disclosed owners & managing parties 8

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

NameRoleSinceShare
Froedtert Thedacare Health, Inc. Organization, Milwaukee, WI Corporation, Non-profit 5% Or Greater Direct Ownership Interest Sep 24, 2019 100%
Matthew R Partridge Individual Corporate OfficerSenior Vice President, Finance Dec 1, 2025
Kara Waggoner Individual Corporate Director Nov 7, 2025
Bryce Gartland Individual Corporate Director May 5, 2025
Michael Degere Individual Corporate Director Aug 7, 2023
Caryn Beth Esten Individual Corporate Director Nov 4, 2022
Allen Ericson Individual Corporate DirectorPresident Sep 24, 2019
W-2 Managing EmployeePresident Sep 24, 2019
Operational/Managerial ControlPresident Sep 24, 2019
Amanda Gonring Individual Corporate Director Feb 2, 2026

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Affiliated clinicians 318

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

View all 318

NPI Registry JSON

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

{
    "created_epoch": "1623369600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1759449600000",
    "number": "1902474430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "N74W12501 LEATHERWOOD CT STE 103",
            "city": "MENOMONEE FALLS",
            "state": "WI",
            "postal_code": "530514490",
            "telephone_number": "414-777-0417",
            "fax_number": "414-777-0096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11421 N PT WASHINGTON RD",
            "city": "MEQUON",
            "state": "WI",
            "postal_code": "53092",
            "telephone_number": "262-518-4910",
            "fax_number": "262-518-4911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FROEDTERT HEALTH NEIGHBORHOOD HOSPITAL, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FROEDTERT HEALTH NEIGHBORHOOD HOSPITAL, LLC",
        "enumeration_date": "2021-06-11",
        "last_updated": "2025-10-03",
        "certification_date": "2025-10-03",
        "status": "A",
        "authorized_official_last_name": "ERICSON",
        "authorized_official_first_name": "ALLEN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "262-836-8092"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Froedtert Community Hospital",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Froedtert Community Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mequon, WI

Sources for this page

Verify at the official NPI Registry.