NPIMap

Ascension Medical Group-Fox Valley Wisconsin, Inc

Organization Active NPI Multi-Specialty Clinic/Center · Winneconne, WI

NPI 1013174465 · NPPES record last updated May 19, 2026

Key facts

NPI
1013174465
Entity type
Organization (NPI type 2)
Primary specialty
Multi-Specialty Clinic/Center 261QM1300X
Legal business name
ASCENSION MEDICAL GROUP-FOX VALLEY WISCONSIN, INC
Practice address
916 E Main St
Winneconne, WI 54986
Phone
(920) 582-1100
NPI assigned
May 21, 2008
Organization subpart
No

Authorized official

Name
David Jirovec
Title
Sr Finance Director - Medical Group
Phone
(715) 347-6655

Corporate family (same tax ID) 30

Organizations that report the same tax identification number in the National Provider Directory.

View all 30

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
52D0398023Ascension Medical Group- Fox Valley Wisconsin Inc
916 E Main St, Winneconne, WI 54986		Certificate of waiverOct 14, 2027

National Provider Directory

Tax ID family
Affinity Medical GRP (31 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X Yes

Addresses

Primary practice location

916 E Main St
Winneconne, WI 54986

Mailing address

916 E Main St
Winneconne, WI 54986-9782
Phone (920) 738-2000

Other identifiers

IdentifierTypeStateIssuer
32752000MedicaidWI

Other names

  • Ascension Medical Group Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on May 19, 2026.

{
    "created_epoch": "1211328000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1779148800000",
    "number": "1013174465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "916 E MAIN ST",
            "city": "WINNECONNE",
            "state": "WI",
            "postal_code": "549869782",
            "telephone_number": "920-738-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "916 E MAIN ST",
            "city": "WINNECONNE",
            "state": "WI",
            "postal_code": "54986",
            "telephone_number": "920-582-1100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASCENSION MEDICAL GROUP-FOX VALLEY WISCONSIN, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-21",
        "last_updated": "2026-05-19",
        "certification_date": "2026-05-19",
        "status": "A",
        "authorized_official_last_name": "JIROVEC",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "SR FINANCE DIRECTOR - MEDICAL GROUP",
        "authorized_official_telephone_number": "715-347-6655"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32752000",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ascension Medical Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Winneconne, WI

All providers in Winneconne, WI · Multi-Specialty Clinic/Center in Wisconsin

Sources for this page

Verify at the official NPI Registry.