| Burnett Medical Center Inc | |
|
257 W Saint George Ave Grantsburg WI 54840-7827 | |
| (715) 463-5317 | |
| Not Available |
| Full Name | Burnett Medical Center Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 257 W Saint George Ave, Grantsburg, Wisconsin |
| Authorized Official Name and Position | Charles J. Faught (CFO) |
| Authorized Official Contact | 7154637281 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Burnett Medical Center Inc 257 W Saint George Ave Grantsburg WI 54840-7827 Ph: (715) 463-5317 | Burnett Medical Center Inc 257 W Saint George Ave Grantsburg WI 54840-7827 Ph: (715) 463-5317 |
| NPI Number | 1356499784 |
|---|---|
| Provider Enumeration Date | 01/08/2007 |
| Last Update Date | 01/04/2012 |
| Medicare PECOS PAC ID | 2163314931 |
|---|---|
| Medicare Enrollment ID | O20040326000457 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356499784 | NPI | - | NPPES |
| 124768 | Medicaid | MN | |
| 001212 | Medicaid | WI | |
| 526247000 | Medicaid | MN | |
| 110166100 | Medicaid | WI |
| Provider Name | Oleg Froymovich |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1417912015 PECOS PAC ID: 9436137155 Enrollment ID: I20040826000233 |
| Provider Name | Patrick G Hall |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1861497364 PECOS PAC ID: 3779529854 Enrollment ID: I20050629000181 |
| Provider Name | Anders E Ulland |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1376620351 PECOS PAC ID: 0749218493 Enrollment ID: I20050803000078 |
| Provider Name | Debra H Hammer |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1194880955 PECOS PAC ID: 1850306325 Enrollment ID: I20060221000134 |
| Provider Name | Blaise P Vitale |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487713723 PECOS PAC ID: 2668487133 Enrollment ID: I20060221000144 |
| Provider Name | Claudio F Nunes |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1053445411 PECOS PAC ID: 9537260963 Enrollment ID: I20070728000214 |
| Provider Name | Norman H Rechsteiner |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1538222450 PECOS PAC ID: 1456420058 Enrollment ID: I20080522000405 |
| Provider Name | Lynn Carlson |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1295850378 PECOS PAC ID: 0941372346 Enrollment ID: I20080630000458 |
| Provider Name | Melinda A Deye |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801056288 PECOS PAC ID: 6305900044 Enrollment ID: I20090126000269 |
| Provider Name | Vincent A Simone |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1427053917 PECOS PAC ID: 2365406048 Enrollment ID: I20090723000802 |
| Provider Name | Timothy G Novick |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1366500753 PECOS PAC ID: 6103960141 Enrollment ID: I20100215000526 |
| Provider Name | James R Kravig |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1063524403 PECOS PAC ID: 1557550233 Enrollment ID: I20110111000770 |
| Provider Name | Muhammad Talha Khan |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1053558676 PECOS PAC ID: 7618191958 Enrollment ID: I20140609000304 |
| Provider Name | Henry K Bong |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1831213438 PECOS PAC ID: 7517140353 Enrollment ID: I20160114001157 |
| Provider Name | Linae M Hicks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841470689 PECOS PAC ID: 2264731827 Enrollment ID: I20160620001604 |
| Provider Name | Mark L Thayer |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1568424778 PECOS PAC ID: 8729117833 Enrollment ID: I20170131000267 |
| Provider Name | Torfi Thorkell Hoskuldsson |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1518129071 PECOS PAC ID: 7810168671 Enrollment ID: I20171011003525 |
| Provider Name | Marilyn A Moffett |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1669519286 PECOS PAC ID: 5193811040 Enrollment ID: I20171206003373 |
| Provider Name | Kathleen M French |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1417157645 PECOS PAC ID: 1658630140 Enrollment ID: I20180108002369 |
| Provider Name | Amy P Wachter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689806622 PECOS PAC ID: 0446397673 Enrollment ID: I20180412000783 |
| Provider Name | Christina Lachae Markovitz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841613619 PECOS PAC ID: 3375773948 Enrollment ID: I20180718004112 |
| Provider Name | James R Natwick |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1912916388 PECOS PAC ID: 0749202091 Enrollment ID: I20190705000478 |
| Provider Name | Abigail R Anderson |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1588155899 PECOS PAC ID: 3577993252 Enrollment ID: I20200421000329 |
| Provider Name | John P Kampa |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1447575469 PECOS PAC ID: 3173838836 Enrollment ID: I20200612000085 |
| Provider Name | Abigail R Dewitt |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1306334321 PECOS PAC ID: 3173871860 Enrollment ID: I20201201000712 |
| Provider Name | Stanley P Dick |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1932163367 PECOS PAC ID: 9739216847 Enrollment ID: I20210104001893 |
| Provider Name | Molly M Ilstrup |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326634478 PECOS PAC ID: 1052725207 Enrollment ID: I20210128002475 |
| Provider Name | Christie D Shelly |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093280349 PECOS PAC ID: 9234483686 Enrollment ID: I20220720001348 |
| Provider Name | Brittany Boss |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1700516200 PECOS PAC ID: 3678957057 Enrollment ID: I20220902001238 |
| Provider Name | Jordan D Fraser |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821650466 PECOS PAC ID: 4486989423 Enrollment ID: I20220902001359 |
| Provider Name | Gretchen Jean Gerovac |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124602081 PECOS PAC ID: 4789085028 Enrollment ID: I20221115002559 |
| Provider Name | Sarah Ogilvie |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467186262 PECOS PAC ID: 9537539069 Enrollment ID: I20221228000742 |
| Provider Name | Christianna L Gratz Carlin |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1063103372 PECOS PAC ID: 0941661763 Enrollment ID: I20230726002776 |
| Provider Name | Cassandra E Carlone |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1699766055 PECOS PAC ID: 8325094360 Enrollment ID: I20231218002764 |