NPIMap

Organization Active NPI

St. Vincent Hospital-Hospital Sisters-Third Order of St Francis

Doing business as Prevea Health

  • Clinical Medical Laboratory
  • Green Bay, WI
National Provider Identifier
1972829554
Registry record updated Dec 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
ST. VINCENT HOSPITAL-HOSPITAL SISTERS-THIRD ORDER OF ST FRANCIS
Doing business as
Prevea Health
Practice address
835 S Van Buren St
Green Bay, WI 54301-3526
Phone
(920) 496-4700
Fax
(920) 405-1402
NPI assigned
Apr 8, 2010
Last updated
Dec 23, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
ST VINCENT HOSPITAL-HOSPITAL SISTERS-THIRD ORDER OF ST FRANCISAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 23, 2021

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

Authorized official

Name
Kelly Gigot
Title
Asst Admin/Chief Financial Officer
Phone
(920) 496-4700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X WI Primary

Addresses

Primary practice location

835 S Van Buren St
Green Bay, WI 54301-3526

Mailing address

835 S Van Buren St
Green Bay, WI 54301-3526
Phone (920) 496-4700

Other names 1

  • Prevea Health Doing business as

Electronic endpoints 1

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

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101029000579 WI Part B Supplier - Independent Clinical Laboratory 5799694675 Practice locations: Green Bay, WI

Other NPIs with the same Medicare PAC ID 15

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 15

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
52D2017862Prevea Health- MFM835 S Van Buren St, Green Bay, WI 54301Certificate of waiverDec 19, 2026

National Provider Directory

National Provider Directory
Tax ID family
St Vincent Hospital Sisters35 organizations share this tax ID, including this one
Part of
St Vincent Hospital Sisters

Other organizations with this tax ID 34

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

View all 34

Locations

1821 S Webster Ave
Green Bay, WI 54301
Phone (920) 431-1850

835 S Van Buren St
Green Bay, WI 54301
Phone (888) 901-7246

Ownership & related parties

All facility ownership & control disclosures 9

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Door County Medical CenterSturgeon Bay, WI, CCN 521358 Hospital Operational/Managerial Control (40%) Nov 1, 2016
Door County Medical Center Swing BedSturgeon Bay, WI, CCN 52Z358 Hospital Operational/Managerial Control (40%) Nov 1, 2016
Pete and Jelaine Horton CenterSturgeon Bay, WI, CCN 525377 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Oct 28, 2016
Feb 14, 2025
UnityDe Pere, WI, CCN 521503 Hospice 5% Or Greater Direct Ownership Interest (45%)
Limited Partnership Interest (45%)
Operational/Managerial Control (45%)		 Oct 1, 1992
Oct 1, 1992
Oct 1, 1992
Door County Medical Center Sturgeon BaySturgeon Bay, WI, CCN 528531 Rural health clinic Operational/Managerial Control (40%) Nov 1, 2016
Door County Medical Center Sister BaySister Bay, WI, CCN 528532 Rural health clinic Operational/Managerial Control (40%) Nov 1, 2016
Door County Medical Center AlgomaAlgoma, WI, CCN 528530 Rural health clinic Operational/Managerial Control (40%) Nov 1, 2016
Door County Medical Center Washington IslandWashington Island, WI, CCN 528515 Rural health clinic Operational/Managerial Control (40%) Nov 1, 2016
DirectcareSturgeon Bay, WI, CCN 528654 Rural health clinic Operational/Managerial Control (40%) Nov 1, 2016

Owned or controlled facilities with NPI records 10

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

NPI Registry JSON

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

{
    "created_epoch": "1270684800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1640217600000",
    "number": "1972829554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "835 S VAN BUREN ST",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543013526",
            "telephone_number": "920-496-4700",
            "fax_number": "920-405-1402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "835 S VAN BUREN ST",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543013526",
            "telephone_number": "920-496-4700",
            "fax_number": "920-405-1402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. VINCENT HOSPITAL-HOSPITAL SISTERS-THIRD ORDER OF ST FRANCIS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ST VINCENT HOSPITAL-HOSPITAL SISTERS-THIRD ORDER OF ST FRANCIS",
        "enumeration_date": "2010-04-08",
        "last_updated": "2021-12-23",
        "certification_date": "2021-12-23",
        "status": "A",
        "authorized_official_last_name": "GIGOT",
        "authorized_official_first_name": "KELLY",
        "authorized_official_title_or_position": "ASST ADMIN/CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "920-496-4700"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "WI",
            "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": "323 S 18th Ave",
            "city": "Sturgeon Bay",
            "state": "WI",
            "country_code": "US",
            "postal_code": "542351401",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Prevea Health",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Prevea Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Green Bay, WI

Sources for this page

Verify at the official NPI Registry.