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

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: November 01, 2026.

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

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
Open in Google Maps ↗

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 ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Wild Rose Community Memorial Hospital, Inc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

52

Medicare enrollment records show 52 clinicians reassign Medicare billing to Wild Rose Community Memorial Hospital, Inc, which bills Medicare for the services they deliver. Of these, 4 practice at this address. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 4

Emergency Medicine41
Nurse Practitioner7
Diagnostic Radiology2
Family Practice2

Nearest to this location (20)

See all 52
Chandler Caves, MD
Emergency Medicine
NPI 1548256019
601 GROVE AVE
Wild Rose, WI 54984
(920) 622-3257
✔ PECOS✔ Accepts MedicareSame address
Joseph Leon, DO
Emergency Medicine
NPI 1912571662
601 GROVE AVE
Wild Rose, WI 54984
(920) 622-3257
✔ PECOS✔ Accepts MedicareSame address
Chad Voskuil, MD
Emergency Medicine
NPI 1639147424
601 GROVE AVE
Wild Rose, WI 54984
(920) 622-3257
✔ PECOS✔ Accepts MedicareSame address
Timothy Roberts, MD
Family Practice
NPI 1386612836
601 GROVE AVE
Wild Rose, WI 54984
(920) 622-3257
✔ PECOS✔ Accepts MedicareSame address
Samuel Docksey, DO
Emergency Medicine
NPI 1578091500
800 RIVERSIDE DR
Waupaca, WI 54981
(715) 258-1041
✔ PECOS✔ Accepts Medicare14 mi
Dennis Ford, MD
Emergency Medicine
NPI 1811078777
800 RIVERSIDE DR
Waupaca, WI 54981
(715) 258-1000
✔ PECOS✔ Accepts Medicare14 mi
Logan Gorges, M.D.
Emergency Medicine
NPI 1295146223
800 RIVERSIDE DR
Waupaca, WI 54981
(715) 258-1000
✔ PECOS✔ Accepts Medicare14 mi
Spencer Greaves, MD
Emergency Medicine
NPI 1457844102
800 RIVERSIDE DR
Waupaca, WI 54981
(715) 258-1000
✔ PECOS✔ Accepts Medicare14 mi
Jessica Kennedy, NP
Nurse Practitioner
NPI 1528797255
800 RIVERSIDE DR
Waupaca, WI 54981
(715) 258-1000
✔ PECOS✔ Accepts Medicare14 mi
Nathan Larsen, M.D.
Emergency Medicine
NPI 1992887848
800 RIVERSIDE DR
Waupaca, WI 54981
(715) 258-1000
✔ PECOS✔ Accepts Medicare14 mi
Christina Nussbaum, M.D.
Emergency Medicine
NPI 1518387885
800 RIVERSIDE DR
Waupaca, WI 54981
(715) 258-1000
✔ PECOS✔ Accepts Medicare14 mi
Lana Sanders, MD
Emergency Medicine
NPI 1376505933
800 RIVERSIDE DR
Waupaca, WI 54981
(715) 258-1000
✔ PECOS✔ Accepts Medicare14 mi
Michael Ward, M.D.
Emergency Medicine
NPI 1316279433
800 RIVERSIDE DR
Waupaca, WI 54981
(715) 258-1000
✔ PECOS✔ Accepts Medicare14 mi
Charles Washington, M.D.
Emergency Medicine
NPI 1124058599
800 RIVERSIDE DR
Waupaca, WI 54981
(715) 258-1000
✔ PECOS✔ Accepts Medicare14 mi
Brice Alvord, M.D.
Diagnostic Radiology
NPI 1679734669
225 MEMORIAL DR
Berlin, WI 54923
(920) 361-5730
✔ PECOS✔ Accepts Medicare21 mi
Erin Eferem, M.D.
Emergency Medicine
NPI 1700106796
225 MEMORIAL DR
Berlin, WI 54923
(920) 361-5525
✔ PECOS✔ Accepts Medicare21 mi
James Heinzen, M.D.
Emergency Medicine
NPI 1013908409
225 MEMORIAL DR
Berlin, WI 54923
(920) 361-5525
✔ PECOS21 mi
Lynn Ringenoldus, APRN-NP
Nurse Practitioner
NPI 1053740761
191 MEMORIAL DR STE 300
Berlin, WI 54923
(920) 361-5717
✔ PECOS✔ Accepts Medicare21 mi
Shawn Williamson, M.D.
Emergency Medicine
NPI 1386808319
1405 MILL ST
New London, WI 54961
(920) 531-2021
✔ PECOS29 mi
Staci Radtke, APNP
Nurse Practitioner
NPI 1558662254
1405 MILL ST
New London, WI 54961
(920) 531-2400
✔ PECOS✔ Accepts Medicare29 mi
See all 52 clinicians

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Thedacare Medical Center - Wild Rose, Inc's NPI number?

The NPI number for Thedacare Medical Center - Wild Rose, Inc is 1043263999. It was assigned to this organization in the NPPES registry on May 19, 2006. The provider is also known as Wild Rose Community Memorial Hospital, Inc.

Where is Thedacare Medical Center - Wild Rose, Inc located?

Thedacare Medical Center - Wild Rose, Inc is located at 601 Grove Ave, Wild Rose, WI 54984. The listed phone number is (920) 622-3257.

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.

Is Thedacare Medical Center - Wild Rose, Inc enrolled in Medicare?

Yes. Thedacare Medical Center - Wild Rose, Inc is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Thedacare Medical Center - Wild Rose, Inc?

According to the CMS Revalidation Reassignment List (October 2026 release), 52 clinicians in 4 Medicare specialties reassign their Medicare billing to Thedacare Medical Center - Wild Rose, Inc. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Emergency Medicine (41), Nurse Practitioner (7) and Diagnostic Radiology (2). Of these, 4 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Thedacare Medical Center - Wild Rose, Inc hold a CLIA laboratory certificate?

Yes. A Certificate of Compliance (number 52D0398014) is associated with this NPI, valid through February 15, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Thedacare Medical Center - Wild Rose, Inc accept?

Health plans from Anthem Blue Cross and Blue Shield, Aspirus Health Plan, CareSource (Common Ground Healthcare), HealthPartners and Network Health and 1 other insurer list Thedacare Medical Center - Wild Rose, Inc as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Thedacare Medical Center - Wild Rose, Inc was last updated on January 3, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.