WILD ROSE COMMUNITY MEMORIAL HOSPITAL, INC
NPI 1043263999
General Acute Care Hospital - Critical Access in Wild Rose, WI

Q: What is Thedacare Medical Center - Wild Rose, Inc's specialty?

The primary specialty registered for this NPI is General Acute Care Hospital, specializing in Critical Access, with taxonomy code 282NC0060X.

Active since May 19, 2006CLIA 52D0398014 · Certificate of Compliance

601 GROVE AVE, WILD ROSE, WI 54984(920) 622-3257(920) 622-5593 Get Directions Write a Review

NPPES record last updated: January 3, 2024. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jan 3, 2024, Sep 6, 2019 (2 updates tracked since 2019).

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About Wild Rose Community Memorial Hospital, Inc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

WILD ROSE COMMUNITY MEMORIAL HOSPITAL, INC (NPI 1043263999) is a healthcare organization registered as a critical access in Wild Rose, Wisconsin and active in the NPI registry since May 2006. The organization holds a CLIA Certificate of Compliance certificate valid through February 15, 2027 and lists William Flett, Cfo, as its authorized official.

NPPES Registry Identity

NPI1043263999

Entity TypeOrganization

Primary Taxonomy282NC0060X

Legal Business NameTHEDACARE MEDICAL CENTER - WILD ROSE, INC

Location Address601 GROVE AVEWild Rose, WI 54984-0243

Mailing Address3 Neenah CtrNeenah, WI 54956-3070 · (920) 830-8900 · Fax (920) 830-5910

Phone(920) 622-3257

Fax(920) 622-5593

Organization SubpartNo

Authorized OfficialWilliam FlettCfo · (920) 454-4013

Enumeration DateMay 19, 2006

Last NPPES UpdateJanuary 3, 20242 updates tracked since enumeration

NPPES CertifiedJanuary 3, 2024

✔ NPI 1043263999 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyGeneral Acute Care Hospital · Critical AccessHospitals

Taxonomy Code282NC0060X

601 GROVE AVE, Wild Rose, WI 54984

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Other Names 1

Other NameWild Rose Community Memorial Hospital, Inc

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Aspirus Health Plan, CareSource (Common Ground Healthcare) and more.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Compliance 52D0398014

Thedacare Medical Center Wild Rose · Wild Rose, WI

Active · expires Feb 15, 2027

CLIA Number52D0398014

Laboratory TypeHospital

Certificate Effective DateFebruary 16, 2025

Certificate Expiration DateFebruary 15, 2027

Laboratory DirectorDr. Eric M. Destrampe

Laboratory Phone(920) 622-5581

Laboratory LocationThedacare Medical Center Wild Rose601 Grove Ave, Wild Rose, WI 54984

CLIA data matches this NPI record on: Address Name

This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Other Providers at the Same Location NPPES 12

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SABAHAT MOHSIN MD

Surgery