Thedacare Regional Medical Center - Appleton, Inc
Organization Active NPI Rehabilitation Hospital Unit · Appleton, WI
NPI 1932085552 · NPPES record last updated Sep 9, 2025
Key facts
- NPI
- 1932085552
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Rehabilitation Hospital Unit 273Y00000X
- Legal business name
- THEDACARE REGIONAL MEDICAL CENTER - APPLETON, INC
- Practice address
- 2400 E Capitol Dr
Appleton, WI 54911-8728 - Phone
- (920) 731-4101
- NPI assigned
- Aug 12, 2025
- Organization subpart
- No
Authorized official
- Name
- William Flett
- Title
- Cfo
- Phone
- (920) 454-4013
Owners & managing parties with NPI records 14
-
David W Koeper, MD
Other NPIs with the same Medicare PAC ID 3
Corporate family (same tax ID) 11
Related certifications (CCN) 7
Facilities with the same owner 26
Practitioners 14
-
Jennifer Marie Bahr, M.D.
-
Aleem Bakhtiar, M.D.
-
Samuel J Docksey, DO
-
Erin K Eferem, M.D.
-
Dennis D Ford, MD
-
David B Hale, MD
-
Nathan Michael Larsen, M.D.
-
Christina Lynne Nussbaum, M.D.
-
Michael Andrew Ward, M.D.
-
Charles D Washington, M.D.
-
Amber Lievens Widenski, D.O.
-
Jocko R Zifferblatt, D.O.
Affiliated clinicians 4
-
Jayden Der, M.D.
-
Carlye Reichert, D.O.
-
Joanne Lin Snow, MD
Medicare Care Compare: Inpatient rehabilitation facility
- Listed as
- Thedacare Regional Medical Center - Appleton Inc
- Ownership
- Non-profit
- Certified
- Oct 1, 2025
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
Hospital certification: CCN 52T160
- Legal name
- THEDACARE REGIONAL MEDICAL CENTER - APPLETON, INC
- Organization structure
- Corporation · Non-profit
- Enrollment address
- 2400 E Capitol Dr
Appleton, WI 54911-8728 - Hospital subgroups
- Rehabilitation unit
All disclosed owners & managing parties 14
| Name | Role | Since | Share |
|---|---|---|---|
| Froedtert Thedacare Health, Inc. |
Operational/Managerial Control | Jan 1, 2024 | |
| Jennifer R Glasheen |
Corporate Director |
Jan 1, 2024 | |
| Laurie a Carter |
Corporate Director |
Feb 11, 2022 | |
| Thedacare, Incorporated |
Operational/Managerial Control | Jan 1, 2024 | |
| Mary W Goggans |
Corporate Director |
Feb 11, 2022 | |
| Alan Loux |
Corporate Director |
Jan 1, 2023 | |
| William Flett |
Corporate Officer |
Oct 31, 2023 | |
| Imran a Andrabi |
Operational/Managerial Control |
Jan 1, 2024 | |
| Chuck Dallas |
Corporate Director |
Jan 1, 2021 | |
| David W Koeper |
Corporate Director |
Jan 1, 2021 | |
| Susan M Pahl |
W-2 Managing Employee |
Jun 1, 2020 | |
| Steven J Price |
Corporate Director |
Jan 1, 2023 | |
| Kathleen Pigeon |
W-2 Managing Employee |
Jun 11, 2020 | |
| Michael Morse |
Corporate Director |
Jan 1, 2024 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20250909001088 | WI | Part a Provider - Hospital | 2163319039 | Practice locations: Appleton, WI |
National Provider Directory
- Tax ID family
- Appleton Medical Center
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rehabilitation Hospital Unit | 273Y00000X | Yes |
Addresses
Primary practice location
2400 E Capitol Dr
Appleton, WI 54911-8728
Mailing address
3 Neenah Ctr
Neenah, WI 54956-3070
Phone (920) 830-5900
Other names
- ThedaCare Appleton In Patient Rehab
- ThedaCare Medical Center Orthopedics, Spine, and Pain Inpt Rehab
Other providers in Appleton, WI
- Theda Care Peabody Manor
- Thedacare Aco, LLC
- Thedacare Inc
- Thedacare Regional Medical Center - Appleton Inc.
- Thedacare Regional Medical Center - Appleton, Inc
- Thedacare Regional Medical Center - Appleton, Inc.
- Thedacare Regional Medical Center - Appleton, Inc.
- Thedacare Regional Medical Center - Appleton, Inc.
- Thedacare Regional Medical Center - Appleton, Inc.
- Thedacare Regional Medical Center - Appleton, Inc.
All providers in Appleton, WI · Rehabilitation Hospital Unit in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 9, 2025. 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.