NPIMap

Organization Active NPI

Ascension Medical Group-Fox Valley Wisconsin, Inc

Doing business as Ascension Medical Group

  • Multi-Specialty Clinic/Center
  • Little Chute, WI
National Provider Identifier
1043478324
Registry record updated May 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
ASCENSION MEDICAL GROUP-FOX VALLEY WISCONSIN, INC
Doing business as
Ascension Medical Group
Practice address
200 Patriot Dr
Little Chute, WI 54140
Phone
(920) 687-2800
NPI assigned
May 23, 2008
Last updated
May 19, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 19, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

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

Specialties & licenses 1

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

Addresses

Primary practice location

200 Patriot Dr
Little Chute, WI 54140

Mailing address

200 Patriot Dr
Little Chute, WI 54140-1184
Phone (920) 738-2000

Other identifiers 1

IdentifierTypeStateIssuer
32752000MedicaidWI

Other names 1

  • Ascension Medical Group Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Affinity Medical GRP31 organizations share this tax ID, including this one

Other organizations with this tax ID 30

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

View all 30

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1211500800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1779148800000",
    "number": "1043478324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 PATRIOT DR",
            "city": "LITTLE CHUTE",
            "state": "WI",
            "postal_code": "541401184",
            "telephone_number": "920-738-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 PATRIOT DR",
            "city": "LITTLE CHUTE",
            "state": "WI",
            "postal_code": "54140",
            "telephone_number": "920-687-2800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASCENSION MEDICAL GROUP-FOX VALLEY WISCONSIN, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-23",
        "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": "NU",
            "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 Little Chute, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.