NPIMap

Organization Active NPI

Family Health Center of Marshfield Inc

Doing business as Family Health Center - Park Falls Dental Center

  • Federally Qualified Health Center (FQHC)
  • Park Falls, WI
National Provider Identifier
1063104297
Registry record updated Sep 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
FAMILY HEALTH CENTER OF MARSHFIELD INC
Doing business as
Family Health Center - Park Falls Dental Center
Park Falls Dental Center
Practice address
75 Sherry Ave
Park Falls, WI 54552-1468
Phone
(715) 762-0200
Fax
(715) 762-1457
NPI assigned
May 25, 2023
Last updated
Sep 22, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2026

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

Authorized official

Name
Gregory Nycz
Title
Ceo
Phone
(608) 217-7484

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X NU Primary

Addresses

Primary practice location

75 Sherry Ave
Park Falls, WI 54552-1468

Mailing address

PO Box 7900
Marshfield, WI 54449-7900
Phone (888) 533-2684

Other identifiers 1

IdentifierTypeStateIssuer
100077248MedicaidWI

Other names 2

  • Family Health Center - Park Falls Dental Center Doing business as
  • Park Falls Dental Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230622000403 WI Part A Provider - Federally Qualified Health Center (FQHC) 2466540877 Practice locations: Park Falls, WI

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1063104297. Details of each certification follow.

Federally qualified health center certification: CCN 521031

Legal name
FAMILY HEALTH CENTER OF MARSHFIELD INC
Doing business as
PARK FALLS DENTAL CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Sep 18, 2023
Last certification
Sep 18, 2023
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
in WI
Enrollment address
75 Sherry Ave
Park Falls, WI 54552-1468

Other NPIs with the same Medicare PAC ID 14

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 14

National Provider Directory

National Provider Directory
Tax ID family
Family Health Center of Marshfield Inc19 organizations share this tax ID, including this one

Other organizations with this tax ID 18

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

View all 18

Locations

75 Sherry Ave
Park Falls, WI 54552
Phone (715) 762-0200

Ownership & related parties

All disclosed owners & managing parties 7

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Amanda Spindler Individual Corporate OfficerCfo Oct 11, 2010
W-2 Managing EmployeeCfo Oct 11, 2010
Ronda L Kopelke Individual Corporate DirectorBoard Vice President Feb 26, 2018
Cindy S Koch Individual Corporate DirectorBoard Secretary Jan 25, 2021
Gregory Nycz Individual Corporate OfficerCeo Sep 25, 1972
W-2 Managing EmployeeCeo Sep 25, 1972
Rita Kirchoff Individual Corporate DirectorBoard Treasurer Feb 24, 2020
Mary Dorsch Individual Corporate OfficerCoo Nov 16, 1998
W-2 Managing EmployeeCoo Nov 16, 1998
Anton J Ziesler Individual Corporate DirectorBoard President Dec 1, 2015

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1684972800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1790035200000",
    "number": "1063104297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7900",
            "city": "MARSHFIELD",
            "state": "WI",
            "postal_code": "544497900",
            "telephone_number": "888-533-2684",
            "fax_number": "715-502-5100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 SHERRY AVE",
            "city": "PARK FALLS",
            "state": "WI",
            "postal_code": "545521468",
            "telephone_number": "715-762-0200",
            "fax_number": "715-762-1457"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY HEALTH CENTER OF MARSHFIELD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-25",
        "last_updated": "2026-09-22",
        "certification_date": "2026-09-22",
        "status": "A",
        "authorized_official_last_name": "NYCZ",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "608-217-7484"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100077248",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Family Health Center - Park Falls Dental Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Park Falls Dental Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Park Falls, WI

Sources for this page

Verify at the official NPI Registry.