Wisconsin Hospitals Provider Directory

1 HospitalsProvider Directory for WisconsinListed in Order of County then City10/01/2019 Provider #Lic #DON NameVendor #Type*Fac#PhoneFaxBedsCountyAccreditedPa rticipation Date AdministratorAddressRegionSub AdministratorFY EndDepartment of Health ServicesDivision of Quality AssuranceHSPLACU1521309101425 CAH43061300 FRIENDSHIP, WI 53934402 W LAKE STMOUNDVIEW MEMORIAL HOSPITAL AND CLINICSADAMSPEREZ-GUERRA, FRANK(608)339-9385(608)339-3331NO04/01/2 001 BRONIEC, DIANASOUTHERNBRONIEC, DIANADECEMBERHSPLACU63521359106535 CAH11019500 ASHLAND, WI 548061615 MAPLE LANEMEMORIAL MEDICAL CENTERASHLANDDOUGLAS, JASON(715)685-4022(715)685-5500 YES10/01/2007 TUTTLE, KATHYNORTHERNHANSEN, KARENSEPTEMBERHSPLACU8521315101825 CAH11016200 BARRON, WI 548121222 E WOODLAND AVEMAYO CLINIC HEALTH SYSTEM-NORTHLANDBARRONHELMERS, RICHARD(715)537-6902(715)537-3186 YES09/01/2001 MILLER, LORI DECEMBERHSPLACU217521353105825 CAH11011600 CUMBERLAND, WI 548291110 7TH AVENUECUMBERLAND MEMORIAL HOSPITALBARRONGUTSCH, MICHAEL(715)822-7151(715)

2 822-7500 YES08/19/2005 LINDBERG, ROBERTWESTERNLINDBERG, ROBERTJUNE1*Type is LTC or Hospital btHospitalsProvider Directory for WisconsinListed in Order of County then City10/01/2019 Provider #Lic #DON NameVendor #Type*Fac#PhoneFaxBedsCountyAccreditedPa rticipation Date AdministratorAddressRegionSub AdministratorFY EndDepartment of Health ServicesDivision of Quality AssuranceHSPLACU525200118240 ACUTE11006900 RICE LAKE, WI 548681700 WEST STOUT STREETMARSHFIELD MEDICAL CENTER - RICE LAKEBARRONGROSETH, BRADLEY(715)236-6342(715)234-1515 YES07/01/1966 OLSON, JOHNJOHNSON, SHERRYSEPTEMBERHSPLACU142520193301167 ACUTE11023500 GREEN BAY, WI 543112845 GREENBRIER RDAURORA BAYCARE MEDICAL CTRBROWNMEYER, DANIEL (920)288-8000 YES11/15/2001 SCHROEDER, HEATHERNORTHEASTERNJERDEE, AMYDECEMBERHSPLACU11520049147244 ACUTE11010200 GREEN BAY, WI 54305744 S WEBSTER AVEBELLIN MEMORIAL HOSPITALBROWNWOLESKE, CHRISTINE(920)433-3707(920)433-3500 YES07/01/1966 HIEB, LAURANORTHEASTERNWOLESKE, CHRISTINEDIETSCHE, JAMESSEPTEMBERHSPLPSY152403826380 PSYCH10065900 GREEN BAY, WI 54301301 E ST JOSEPH STBELLIN PSYCHIATRIC CENTERBROWNBAENEN, SHARLA(920)437-0533(920)

3 433-3630 YES08/29/1990 PATZ, DEBBIENORTHEASTERNWOLESKE, CHRIS2*Type is LTC or Hospital btHospitalsProvider Directory for WisconsinListed in Order of County then City10/01/2019 Provider #Lic #DON NameVendor #Type*Fac#PhoneFaxBedsCountyAccreditedPa rticipation Date AdministratorAddressRegionSub AdministratorFY EndDepartment of Health ServicesDivision of Quality AssuranceHSPLPSY252401421316 PSYCH10064500 GREEN BAY, WI 543113150 GERSHWIN DRIVEBROWN COUNTY COMMUNITY TREATMENT CTRBROWNBEHLING, SAMANTHA(920)391-4872(920)391-4700NO11/0 5/1969 BEHLING, SAMANTHANORTHEASTERN DECEMBERHSPSAT00125924 SATELLITE10065600 GREEN BAY, WI 543031701 DOUSMAN STLIBERTAS GREEN BAYBROWNCHARLIER, BRIAN(920)496-2027(920)498-8600 YESHAFEMAN, PAULANORTHEASTERNDOXTATOR, ELAINEJUNEHSPLACU11252009718158 ACUTE11013800 GREEN BAY, WI 543031726 SHAWANO AVEST MARYS HOSPITAL MEDICAL CTRBROWNCHARLIER, BRIAN(920)431-3248(920)498-4200 YES07/01/1966 HAFEMAN, PAULANORTHEASTERN JUNEHSPLACU12152007519517 ACUTE11012100 GREEN BAY, WI 54301835 S VAN BUREN STST VINCENT HOSPITALBROWNCHARLIER, BRIAN(920)431-3248(920)

4 433-0111 YES07/01/1966 HAFEMAN, PAULANORTHEASTERN JUNE3*Type is LTC or Hospital btHospitalsProvider Directory for WisconsinListed in Order of County then City10/01/2019 Provider #Lic #DON NameVendor #Type*Fac#PhoneFaxBedsCountyAccreditedPa rticipation Date AdministratorAddressRegionSub AdministratorFY EndDepartment of Health ServicesDivision of Quality AssuranceHSPLPSY1452404132272 PSYCHGREEN BAY, WI 543111351 ONTARIO RDWILLOW CREEK BEHAVIORAL HEALTHBROWNAHUJA, TEENA(901)469-7213(901)328-1220 YES02/27/2017 DENIL, ALISONFRIZZELL, LAMARDECEMBERHSPLACU17521331103425 CAH11016600 GRANTSBURG, WI 54840257 W ST GEORGE AVEBURNETT MEDICAL CENTERBURNETTLEWIS, GORDON(715)463-2423(715)463-5353NO10/01/ 2003 MOORE, JAMESFOYBORT, GORDYSEPTEMBERHSPLCRI11521317102025 CAH11015300 CHILTON, WI 53014614 MEMORIAL DRIVEASCENSION CALUMET HOSPITALCALUMETDERKS, JENNIFER(920)849-7510(920)849-2386 YES11/02/2001 STRODTHOFF, JUDITHNORTHEASTERNWEBER, JENNIFERJUNEHSPLACU15521314101725 CAH11018500 BLOOMER, WI 547241501 THOMPSON STMAYO CLINIC HEALTH SYSTEM-CHIPPEWA VALLEYCHIPPEWAHELMERS, RICHARD(715)568-6196(715)

5 568-2000 YES07/01/2001 MILLER, LORI DECEMBER4*Type is LTC or Hospital btHospitalsProvider Directory for WisconsinListed in Order of County then City10/01/2019 Provider #Lic #DON NameVendor #Type*Fac#PhoneFaxBedsCountyAccreditedPa rticipation Date AdministratorAddressRegionSub AdministratorFY EndDepartment of Health ServicesDivision of Quality AssuranceHSPLACU10152001715193 ACUTE11007500 CHIPPEWA FALLS, WI 547292661 COUNTY HWY IST JOSEPHS HOSPITALCHIPPEWAOLAND, CHARISSE(715)717-1694(715)717-7200 YES07/01/1966 BALCITIS, JUDYBALCITIS, JUDYJUNEHSPLACU131521311101324 CAH11006500 STANLEY, WI 547681120 PINE STASCENSION OUR LADY OF VICTORY HOSPITALCHIPPEWAGAPKO, DAWN(715)644-6221(715)644-5571NO03/07/20 01 RENAUD, KIMBERLYWESTERNCHAPEK, LACEYJUNEHSPLACU62521323102625 CAH11010500 NEILLSVILLE, WI 54456216 SUNSET PLACEMARSHFIELD MEDICAL CENTER - NEILLSVILLECLARKNEVILLE, RYAN(715)743-8015(715)743-3101NO08/01/20 02 ZILLMAN, SALLYSILBERNAGEL, KELLYDECEMBERHSPLACU23521338104225 CAH11012800 COLUMBUS, WI 539251515 PARK AVECOLUMBUS COMMUNITY HOSPITALCOLUMBIARUSSELL, JOHN(920)623-3546(920)

6 623-2200 YES07/01/2004 HENDRIX, JAMIESOUTHERNFISH, FRANCISSEPTEMBER5*Type is LTC or Hospital btHospitalsProvider Directory for WisconsinListed in Order of County then City10/01/2019 Provider #Lic #DON NameVendor #Type*Fac#PhoneFaxBedsCountyAccreditedPa rticipation Date AdministratorAddressRegionSub AdministratorFY EndDepartment of Health ServicesDivision of Quality AssuranceHSPLACU275200418073 ACUTE11009500 PORTAGE, WI 539012817 NEW PINERY ROADDIVINE SAVIOR HEALTHCARECOLUMBIADECKER, MICHAEL(608)742-6098(608)742-4131 YES07/01/1966 BAUMAN, JANSOUTHERNBAUMAN, JANJUNEHSPLACU71521330103325 CAH32811100 PRAIRIE DU CHIEN, WI 5382137868 US HWY 18 CROSSING RIVERS HEALTH MEDICAL CENTERCRAWFORDSEXTON, WILLIAM(608)357-2100(608)357-2000 YES10/01/2003 PRITCHETT, JENNYWESTERNNELSON, JULIADECEMBERHSPLPSY5524008249394 PSYCH10063400 MADISON, WI 53704301 TROY DRMENDOTA MENTAL HEALTH INSTITUTEDANEVAN RYBROEK, GREG(608)301-1390(608)301-1000 YES07/01/1966 VON HADEN, LISASOUTHERNLANE, PAULJUNEHSPLACU99252200831358LT11025100 MADISON, WI 53715801 BRAXTON PLACESELECT SPECIALTY HOSPITAL MADISONDANETHEROULT, TOM(608)260-2729(608)

7 260-2700 YES06/01/2007 BEAUDETTE, JEANSOUTHERNTHEROULT, TOMDECEMBER6*Type is LTC or Hospital btHospitalsProvider Directory for WisconsinListed in Order of County then City10/01/2019 Provider #Lic #DON NameVendor #Type*Fac#PhoneFaxBedsCountyAccreditedPa rticipation Date AdministratorAddressRegionSub AdministratorFY EndDepartment of Health ServicesDivision of Quality AssuranceHSPLACU11152008371440 ACUTE11022900 MADISON, WI 53715700 SOUTH PARK STSSM HEALTH ST MARY'S HOSPITAL - MADISONDANEROZENFELD, JON(608)258-6731(608)251-6100 YES07/01/1966 MALONE, GINGERSOUTHERNROZENFELD, JONDECEMBERHSPLACU66520089248426 ACUTE11001700 MADISON, WI 53715202 S PARK STUNITYPOINT HEALTH - MERITERDANEERICKSON, SUSAN (608)417-6000 YES07/01/1966 CASALI, SHERRYSOUTHERNARNETT, JAMESDECEMBERHSPSAT00575222 SATELLITE11001700 MADISON, WI 537198001 RAYMOND RDUNITYPOINT HEALTH MERITER CHILD & ADOLESCENT PSYCHDANEMCGLYNN, KATHERINE(608)417-5334(608)417-5336 YESCASALI, SHERRYSOUTHERNBENNETT, CLARKDECEMBERHSPLACU127520098125672 ACUTE11022000 MADISON, WI 53792600 HIGHLAND AVENUEUNIVERSITY OF WI Hospitals & CLINICS AUTHORITYDANEBOLT, ELIZABETH(608)662-3050(608)

8 261-0025 YES07/01/1966 HOULAHAN, BETHSOUTHERNNEWCOMER, PETERJUNE7*Type is LTC or Hospital btHospitalsProvider Directory for WisconsinListed in Order of County then City10/01/2019 Provider #Lic #DON NameVendor #Type*Fac#PhoneFaxBedsCountyAccreditedPa rticipation Date AdministratorAddressRegionSub AdministratorFY EndDepartment of Health ServicesDivision of Quality AssuranceWITH00232529802 TRANSPLANTMADISON, WI 53792600 HIGHLAND AVEUNIVERSITY OF Wisconsin Hospitals AND CLINICSDANE(608)265-5568(608)265-7050NO0 9/23/2009 HSPLRHB0152302832150 REHABMADISON, WI 537185115 N BILTMORE LNUW HEALTH REHABILITATION HOSPITALDANEDIDERRICH, MARY KAY(608)592-8170(608)592-8100 YES10/26/2015 DIDERRICH, MARY KAYHERMAN, BRIANDECEMBERHSPLACU122521343104635 CAH11007200 STOUGHTON, WI 53589900 RIDGE STSTOUGHTON HOSPITALDANEDEGROOT, DANIEL(608)873-2315(608)873-6611 YES10/01/2004 HERMES, AMYSOUTHERNABEY, MICHELLESEPTEMBERHSPLACU10520076199125 ACUTE11012200 BEAVER DAM, WI 53916707 S UNIVERSITY AVEBEAVER DAM COMMUNITY HOSPITALDODGEGILENE, JOSEPH(920)887-7973(920)

9 887-7181 YES07/01/1966 SMITH, COLLETTESOUTHERNBRUINS, MELANIEJUNE8*Type is LTC or Hospital btHospitalsProvider Directory for WisconsinListed in Order of County then City10/01/2019 Provider #Lic #DON NameVendor #Type*Fac#PhoneFaxBedsCountyAccreditedPa rticipation Date AdministratorAddressRegionSub AdministratorFY EndDepartment of Health ServicesDivision of Quality AssuranceHSPLACU13252011610595 ACUTE11015400 WATERTOWN, WI 53098125 HOSPITAL DRIVEWATERTOWN REGIONAL MEDICAL CENTERDODGEKEDDINGTON, RICHARD(920)261-3940(920)261-4210 YES07/01/1966 GARABALDI, ISABELLESOUTHERNGARABALDI, ISABELLEAUGUSTHSPLACU134521327103125 CAH11008100 WAUPUN, WI 53963620 W BROWN STWAUPUN MEMORIAL HOSPITALDODGETHURMER, DEANN(920)324-2085(920)324-6512 YES02/01/2003 THURMER, DEANNSOUTHERN DECEMBERHSPLCRI20521358106425 CAH11018400 STURGEON BAY, WI 54235323 SOUTH 18TH AVENUEDOOR COUNTY MEDICAL CENTERDOORSTEPHENS, BRIAN (920)743-5566NO06/13/2006 KRAUSE, CHRISTANORTHEASTERNSTEPHENS, BRIANJUNEHSPLACU92521329103225 CAH11022400 SUPERIOR, WI 548803500 TOWER AVEESSENTIA HEALTH ST MARY'S HOSPITAL - SUPERIORDOUGLASJACOBSON, TERRY (715)

10 817-7000 YES08/01/2003 PEARSON, KIMNORTHERNGARVEY, JIMJUNE9*Type is LTC or Hospital btHospitalsProvider Directory for WisconsinListed in Order of County then City10/01/2019 Provider #Lic #DON NameVendor #Type*Fac#PhoneFaxBedsCountyAccreditedPa rticipation Date AdministratorAddressRegionSub AdministratorFY