NPIMap

Organization Active NPI

Thedacare Medical Center - New London, Inc

  • Ambulance
  • New London, WI
National Provider Identifier
1992848790
Registry record updated Jan 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
AmbulanceTaxonomy code 341600000X
License
60-01246 Issued in WI
Legal business name
THEDACARE MEDICAL CENTER - NEW LONDON, INC
Practice address
1405 Mill St
New London, WI 54961-2155
Phone
(920) 531-2092
Fax
(920) 531-2098
NPI assigned
Feb 14, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2024

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

Authorized official

Name
Mr. William Flett
Title
Cfo
Phone
(920) 454-4013

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulance 341600000X 60-01246 WI Primary

Addresses

Primary practice location

1405 Mill St
New London, WI 54961-2155

Mailing address

3 Neenah Ctr
Neenah, WI 54956-3070
Phone (920) 830-8900

Other identifiers 1

IdentifierTypeStateIssuer
41348200MedicaidWI

National Provider Directory

National Provider Directory
Tax ID family
New London FM Med Ctr5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

NPI Registry JSON

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

{
    "created_epoch": "1171411200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704240000000",
    "number": "1992848790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 NEENAH CTR",
            "city": "NEENAH",
            "state": "WI",
            "postal_code": "549563070",
            "telephone_number": "920-830-8900",
            "fax_number": "920-830-5910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1405 MILL ST",
            "city": "NEW LONDON",
            "state": "WI",
            "postal_code": "549612155",
            "telephone_number": "920-531-2092",
            "fax_number": "920-531-2098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THEDACARE MEDICAL CENTER - NEW LONDON, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-14",
        "last_updated": "2024-01-03",
        "certification_date": "2024-01-03",
        "status": "A",
        "authorized_official_last_name": "FLETT",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "920-454-4013",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "WI",
            "license": "60-01246",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41348200",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New London, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2024; 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.