THEDACARE MEDICAL CENTER - SHAWANO, INC.
NPI 1548260839
General Acute Care Hospital - Critical Access in Shawano, WI
NPI Status: Active since July 28, 2005
Contact Information
100 COUNTY ROAD B
SHAWANO, WI
ZIP 54166
Phone: (715) 526-2111
Fax: (715) 526-7308
- Organization
- General Acute Care Hospital
- Critical Access
- Accepts Insurance
- CLIA Number: 52D0662725
- CLIA Cert. Type: Public Health Laboratories
- CLIA Exp. Date: 08-31-2026
About THEDACARE MEDICAL CENTER - SHAWANO, INC.
This page provides the complete NPI Profile along with additional information for Thedacare Medical Center - Shawano, Inc., a provider established in Shawano, Wisconsin operating as a General Acute Care Hospital, focusing in critical access . The healthcare provider is registered in the NPI registry with number 1548260839 assigned on July 2005. The practitioner's primary taxonomy code is 282NC0060X with license number 1051 (WI). The provider is registered as an organization and their NPI record was last updated 2 years ago. The provider's former legal business name is Shawano Medical Center, Inc.. The authorized official of this NPI record is William Flett (Cfo)
- NPI
- 1548260839
- Provider Legal Name
- THEDACARE MEDICAL CENTER - SHAWANO, INC.
- Other Organization Name
- SHAWANO MEDICAL CENTER, INC.
- Other Name Type
- Former Legal Business Name (4)
- Entity Type
- Organization
- Location Address
- 100 COUNTY ROAD B SHAWANO, WI 54166
- Location Phone
- (715) 526-2111
- Location Fax
- (715) 526-7308
- Mailing Address
- 3 NEENAH CTR NEENAH, WI 54956
- Mailing Phone
- (920) 830-5900
- Mailing Fax
- (715) 526-7308
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 07-28-2005
- Last Update Date
- 01-03-2024
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
General Acute Care Hospital Critical Access
- Taxonomy Code
- 282NC0060X
- Type
- Hospitals
- License No.
- 1051
- License State
- WI
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Anthem Bronze Preferred/Broad 5000 (3 Free PCP Visits + $0 Select Drugs + Incentives) - POS
- Anthem Bronze Preferred/Broad HSA (+ Incentives) - POS
- Anthem Bronze Preferred/Broad Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
- Anthem Bronze Priority/Lean 5000 (3 Free PCP Visits + $0 Select Drugs + Incentives) - HMO
- Anthem Bronze Priority/Lean HSA (+ Incentives) - HMO
- Anthem Bronze Priority/Lean Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Anthem Gold Preferred/Broad 1000 ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
- Anthem Gold Preferred/Broad Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
- Anthem Gold Priority/Lean 1000 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Anthem Gold Priority/Lean Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- HMO Bronze $0 Medical Deductible - HMO
- HMO Bronze 7500 - HMO
- HMO Catstrophic 9200 with 3 Free PCP Visits - HMO
- HMO Gold 1500 - HMO
- HMO Gold 2400 - HMO
- HMO HDHP Bronze 7200 - HMO
- HMO HDHP Silver 5400 - HMO
- HMO Silver 5000 - HMO
- HMO Silver 6600 - HMO
- POS Bronze 7500 - POS
- CGHC Bronze $0 Ded / $2250 Rx Ded - Envision Network - EPO
- CGHC Bronze $0 Ded / $2250 Rx Ded - Envision Network (Vision Exam) - EPO
- CGHC Bronze $9200 ($40 PCP Copay) - Envision Network - EPO
- CGHC Bronze $9200 ($40 PCP Copay) - Envision Network (Vision Exam) - EPO
- CGHC Bronze Standard $7500 - Envision Network - EPO
- CGHC Bronze Standard $7500 - Envision Network (Vision Exam) - EPO
- CGHC Catastrophic $9200 - Envision Network - EPO
- CGHC Gold $0 Ded - Envision Network - EPO
- CGHC Gold $0 Ded - Envision Network (Vision Exam) - EPO
- CGHC Gold $3000 - Envision Network - EPO
- Robin Select $2,800 Plus Silver - PPO
- Robin Select $3,500 HSA Silver - PPO
- Robin Select $5,000 Standard Silver - PPO
- Robin Select $6,500 Plus Bronze - PPO
- Robin Select $7,500 Standard Bronze - PPO
- Robin Select $8,200 HSA Bronze - PPO
- Robin Select $9,200 Catastrophic - PPO
- QUARTZ GUNDERSEN PERFORMANCE BRONZE $0 MEDICAL DED - HMO
- QUARTZ GUNDERSEN PERFORMANCE BRONZE $7250 HSA - HMO
- QUARTZ GUNDERSEN PERFORMANCE BRONZE (DENTAL & VISION) $0 MEDICAL DED - HMO
- QUARTZ GUNDERSEN PERFORMANCE BRONZE (DENTAL & VISION) STANDARD EASY PRICING - HMO
- QUARTZ GUNDERSEN PERFORMANCE BRONZE STANDARD EASY PRICING - HMO
- QUARTZ GUNDERSEN PERFORMANCE CATASTROPHIC $9200 DED - HMO
- QUARTZ GUNDERSEN PERFORMANCE GOLD $2500 DED - HMO
- QUARTZ GUNDERSEN PERFORMANCE GOLD (DENTAL & VISION) $2500 DED - HMO
- QUARTZ GUNDERSEN PERFORMANCE GOLD (DENTAL & VISION) STANDARD EASY PRICING - HMO
- QUARTZ GUNDERSEN PERFORMANCE GOLD MAINTENANCE $500 DED - HMO
- Premier $1,500 - 25% - HMO
- Premier $3,500 - 30% - HMO
- Premier $4,100 HDHP - HMO
- Premier $5,000 - 40% - HMO
- Premier $6,200 HDHP - HMO
- Premier $7,500 - HMO
- Premier $9,200 - HMO
- Premier Protection - HMO
- Premier HMO $1,500 - 30% - HMO
- Premier HMO $2,500 - 20% Copay - HMO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 41173800 | MEDICAID (05) | WI | |
| 11013400 | MEDICAID (05) | WI | |
| 11013410 | MEDICAID (05) | WI | |
| 32944300 | MEDICAID (05) | WI | |
| 32762800 | MEDICAID (05) | WI |
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 52D0662725
- Facility Type
- Public Health Laboratories
- Certificate Effective Date
- September 01, 2024
- Certificate Expiration Date
- August 31, 2026
- Laboratory Director
- THERESA A. HARMALA
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Thedacare Medical Center - Shawano, Inc. to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
Reviews for THEDACARE MEDICAL CENTER - SHAWANO, INC.
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 5 | 4 | 8 | 2 | 6 | 0 | 8 | 3 | 9 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 5 | 8 | 8 | 4 | 6 | 0 | 8 | 6 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 5 + 8 + 8 + 4 + 6 + 0 + 8 + 6 + 24 = 71 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 80 - 71 = 9 | 9 | ||||||||
The NPI number 1548260839 is valid because the calculated check digit 9 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 20 providers are registered at the same or nearby location.
ANN M TOUSIGNANT MD
Obstetrics & Gynecology
100 COUNTY ROAD B
SHAWANO, WI
ZIP 54166
JEFFREY LEE MINIKEL MD
Orthopaedic Surgery
100 COUNTY ROAD B
SHAWANO, WI
ZIP 54166
THOMAS L OLMSTED CRNA
Nurse Anesthetist, Certified Registered
100 COUNTY ROAD B
SHAWANO, WI
ZIP 54166
KATHLEEN QUALHEIM MD
Family Medicine
100 COUNTY ROAD B
SHAWANO, WI
ZIP 54166
GREGORY THATCHER MD
Family Medicine
100 COUNTY ROAD B
SHAWANO, WI
ZIP 54166
SUSAN GRUETZMACHER NP
Physician Assistant
(Medical)
100 COUNTY ROAD B
SHAWANO, WI
ZIP 54166
JOHN D SCHARINE CRNA
Nurse Anesthetist, Certified Registered
100 COUNTY ROAD B
SHAWANO, WI
ZIP 54166
JOHN E SCHREINER CRNA
Nurse Anesthetist, Certified Registered
100 COUNTY ROAD B
SHAWANO, WI
ZIP 54166
DR. MINDY MARIA FRIMODIG DO
Family Medicine
100 COUNTY ROAD B
SHAWANO, WI
ZIP 54166
DR. MICHAEL E WEST MD
Obstetrics & Gynecology
100 COUNTY ROAD B
SHAWANO, WI
ZIP 54166
DR. JOHN EDWARD LAABS M.D.
Family Medicine
100 COUNTY ROAD B
SHAWANO, WI
ZIP 54166
JILL OLSEN APNP
Nurse Practitioner
100 COUNTY ROAD B
SHAWANO, WI
ZIP 54166
ANGELA DAWN DIVJAK MD
Family Medicine
100 COUNTY ROAD B
SHAWANO, WI
ZIP 54166
CHERYLE L RICHTER
Pharmacist
100 COUNTY ROAD B
SHAWANO, WI
ZIP 54166
JASON J KRUEGER APNP
Nurse Practitioner
100 COUNTY ROAD B
SHAWANO, WI
ZIP 54166
LENORE K WESPETAL CD
Dietitian, Registered
100 COUNTY ROAD B
SHAWANO, WI
ZIP 54166
WILL GILLIS PHARMD
Pharmacist
100 COUNTY ROAD B
SHAWANO, WI
ZIP 54166
DIANA J SCHARINE APNP
Nurse Practitioner
100 COUNTY ROAD B
SHAWANO, WI
ZIP 54166
MARGARET L PIEPER CD
Dietitian, Registered
100 COUNTY ROAD B
SHAWANO, WI
ZIP 54166
DR. CLAY A CANADAY DO
Orthopaedic Surgery
100 COUNTY ROAD B
SHAWANO, WI
ZIP 54166
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1548260839, enumerated as an "organization" on July 28, 2005.
The provider is located at 100 COUNTY ROAD B SHAWANO, WI 54166 and the phone number is (715) 526-2111.
General Acute Care Hospital with taxonomy code 282NC0060X and a focus in Critical Access.
The provider might be accepting Accepts: Anthem Blue Cross and Blue Shield, Aspirus Health. Please consult your insurance carrier or call the provider to verify.
