FOND DU LAC DIALYSIS CENTER
NPI 1619955838
Clinic/Center - End-Stage Renal Disease (ESRD) Treatment in Fond Du Lac, WI

Q: What is Waupun Memorial Hospital's NPI number?

The NPI number for Waupun Memorial Hospital is 1619955838. It was assigned to this organization in the NPPES registry on January 6, 2006. The provider is doing business as Fond Du Lac Dialysis Center and SSM Health Dialysis Center.

Q: What is Waupun Memorial Hospital's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in End-Stage Renal Disease (ESRD) Treatment, with taxonomy code 261QE0700X.

Q: What quality rating does Waupun Memorial Hospital have?

CMS rates DaVita Fond Du Lac Dialysis 2 out of 5 stars on Care Compare. The full measure detail is in the Dialysis Facility Quality section above.

Active since January 06, 2006CLIA 52D0997010 · Waiver

2/5

Overall Rating

101 S PIONEER RD, FOND DU LAC, WI 54935(920) 923-2333(920) 926-8885 Get Directions Write a Review

NPPES record last updated: March 12, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Fond Du Lac Dialysis Center NPPES

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

FOND DU LAC DIALYSIS CENTER (NPI 1619955838) is a healthcare organization registered as an end-stage renal disease (esrd) treatment in Fond Du Lac, Wisconsin and active in the NPI registry since January 2006. The organization holds a CLIA Waiver certificate valid through March 3, 2028 and lists Steven N Little, Svp & Cfo, as its authorized official.

NPPES Registry Identity

NPI1619955838

Entity TypeOrganization

Primary Taxonomy261QE0700X

Legal Business NameWAUPUN MEMORIAL HOSPITAL

Location Address101 S PIONEER RDFond Du Lac, WI 54935-3871

Mailing AddressPo Box 1283Fond Du Lac, WI 54936-1283 · (920) 926-4472 · Fax (920) 926-8885

Phone(920) 923-2333

Fax(920) 926-8885

Organization SubpartNo

Authorized OfficialSteven N LittleSvp & Cfo · (920) 926-5402

Enumeration DateJanuary 6, 2006

Last NPPES UpdateMarch 12, 2022

NPPES CertifiedMarch 12, 2022

✔ NPI 1619955838 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · End-Stage Renal Disease (ESRD) TreatmentAmbulatory Health Care Facilities

Taxonomy Code261QE0700X

101 S PIONEER RD, Fond Du Lac, WI 54935

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Other Names 2

Doing Business AsFond Du Lac Dialysis Center

Doing Business AsSsm Health Dialysis Center

Other Identifiers 3

Medicaid42052300WI

Other42052300WI · Wi Chronic Disease Progra

OtherZ3WI · Dean Care

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Network Health, Quartz.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 Waiver 52D0997010

Fond Du Lac Dialysis · Fond Du Lac, WI

Active · expires Mar 3, 2028

CLIA Number52D0997010

Laboratory TypeEnd Stage Renal Disease Dialysis Facility

Certificate Effective DateMarch 4, 2026

Certificate Expiration DateMarch 3, 2028

Laboratory DirectorAlan Moreno

Laboratory Phone(920) 907-7120

Laboratory LocationFond Du Lac Dialysis210 Wisconsin American Dr, Fond Du Lac, WI 54935

CLIA data matches this NPI record on: Name

This certificate is issued to a laboratory to perform only waived tests.

Dialysis Facility Quality Ratings CMS Care Compare

Quality ratings, services and patient survey results for DaVita Fond Du Lac Dialysis (CMS certification number 522526), from CMS Care Compare.

DaVita Fond Du Lac Dialysis

Dialysis facility · Fond Du Lac, WI

2/5 CMS RatingRating period January 2020 to December 2023

OwnershipProfit

ChainDaVita

CMS Certification Number522526

ESRD NetworkNetwork 11

Hemodialysis Stations9

Medicare-Certified SinceJune 30, 1998

Location210 WISCONSIN AMERICAN DR ATTN DAVITA DIALYSIS (WEST END OF BLDG)Fond Du Lac, WI 54937 · Fond du Lac County

Phone(920) 907-0689

Services Offered

In-center hemodialysis

Other Providers at the Same Location NPPES

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

ALESHIA M COLE NP

Nurse Practitioner

101 S PIONEER RD
FOND DU LAC, WI 54935

Fond Du Lac County (920) 923-2333

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 Waupun Memorial Hospital's NPI number?

The NPI number for Waupun Memorial Hospital is 1619955838. It was assigned to this organization in the NPPES registry on January 6, 2006. The provider is doing business as Fond Du Lac Dialysis Center and SSM Health Dialysis Center.

Where is Waupun Memorial Hospital located?

Waupun Memorial Hospital is located at 101 S Pioneer Rd, Fond Du Lac, WI 54935. The listed phone number is (920) 923-2333.

What is Waupun Memorial Hospital's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in End-Stage Renal Disease (ESRD) Treatment, with taxonomy code 261QE0700X.

Does Waupun Memorial Hospital hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 52D0997010) is associated with this NPI, valid through March 3, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

Is Waupun Memorial Hospital a Medicare-certified dialysis facility?

Yes. DaVita Fond Du Lac Dialysis is a Medicare-certified dialysis facility, certified since June 30, 1998.

What quality rating does Waupun Memorial Hospital have?

CMS rates DaVita Fond Du Lac Dialysis 2 out of 5 stars on Care Compare. The full measure detail is in the Dialysis Facility Quality section above.

What insurance does Waupun Memorial Hospital accept?

Health plans from Anthem Blue Cross and Blue Shield, Network Health and Quartz list Waupun Memorial Hospital 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 Waupun Memorial Hospital was last updated on March 12, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.