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SSM HEALTH FOND DU LAC REGIONAL CLINIC
NPI 1215402334
Durable Medical Equipment & Medical Supplies in Beaver Dam, WI

Active since October 04, 2018
130 CORPORATE DR, BEAVER DAM, WI 53916(920) 887-3102 Get Directions Write a Review

NPPES record last updated: June 5, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jun 5, 2024, Jan 24, 2022, May 23, 2019 and 1 more (4 updates tracked since 2018).

About Ssm Health Fond Du Lac Regional Clinic NPPES

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

SSM HEALTH FOND DU LAC REGIONAL CLINIC (NPI 1215402334) is a healthcare organization registered as a durable medical equipment & medical supplies in Beaver Dam, Wisconsin and active in the NPI registry since October 2018. The organization lists Amy Grinnell, Vp-finance, Cfo, as its authorized official.

NPPES Registry Identity

NPI1215402334
Entity TypeOrganization
Primary Taxonomy332B00000X
Legal Business NameAGNESIAN HEALTHCARE INC
Location Address130 CORPORATE DRBeaver Dam, WI 53916-3116
Mailing Address420 E Division StFond Du Lac, WI 54935-4560 · (920) 926-8332
Phone(920) 887-3102
Organization SubpartNo
Authorized OfficialAmy GrinnellVp-finance, Cfo · (608) 260-3586
Enumeration DateOctober 4, 2018
Last NPPES UpdateJune 5, 20244 updates tracked since enumeration
NPPES CertifiedJune 5, 2024
✔ NPI 1215402334 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDurable Medical Equipment & Medical SuppliesSuppliers
Taxonomy Code332B00000X
Definition
A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time.
130 CORPORATE DR, Beaver Dam, WI 53916
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Other Names 1

Doing Business AsSsm Health Fond Du Lac Regional Clinic

Other Providers at the Same Location NPPES 16

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

DEAN HEALTH SYSTEMS, INC.
Durable Medical Equipment & Medical Supplies
130 CORPORATE DR
BEAVER DAM, WI 53916
Dodge County (920) 877-3102
HEIDI BAILEY
Nurse Practitioner (Family)
130 CORPORATE DR
BEAVER DAM, WI 53916
Dodge County (920) 887-3102
CATHERINE EM NELSON
Family Medicine
130 CORPORATE DR
BEAVER DAM, WI 53916
Dodge County (920) 877-3102
JAYME K QUADE APNP
Nurse Practitioner
130 CORPORATE DR
BEAVER DAM, WI 53916
Dodge County (920) 887-3102
LYNDSEY CHRISTENSON APNP
Nurse Practitioner
130 CORPORATE DR
BEAVER DAM, WI 53916
Dodge County (920) 887-3102
COLLEEN F CASSIDY MD
Family Medicine
130 CORPORATE DR
BEAVER DAM, WI 53916
Dodge County (920) 887-3102
CONSULTANTS LABORATORY OF WISCONSIN, LLC
Clinical Medical Laboratory
130 CORPORATE DR
BEAVER DAM, WI 53916
Dodge County (920) 926-5840
ERIN R LAMBERT DO
Family Medicine
130 CORPORATE DR
BEAVER DAM, WI 53916
Dodge County (920) 887-3102

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 Agnesian Healthcare Inc's NPI number?

The NPI number for Agnesian Healthcare Inc is 1215402334. It was assigned to this organization in the NPPES registry on October 4, 2018. The provider is doing business as Ssm Health Fond Du Lac Regional Clinic.

Where is Agnesian Healthcare Inc located?

Agnesian Healthcare Inc is located at 130 Corporate Dr, Beaver Dam, WI 53916. The listed phone number is (920) 887-3102.

What is Agnesian Healthcare Inc's specialty?

The primary specialty registered for this NPI is Durable Medical Equipment & Medical Supplies with taxonomy code 332B00000X.

When was this NPI record last updated?

The NPPES record for Agnesian Healthcare Inc was last updated on June 5, 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.