NPIMap

Organization Active NPI

Sauk Prairie Healthcare Inc

  • Rural Health Clinic/Center
  • Mazomanie, WI
National Provider Identifier
1073588299
Registry record updated Sep 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
SAUK PRAIRIE HEALTHCARE INC
Practice address
506 Crocker St Ste 3
Mazomanie, WI 53560-9426
Phone
(608) 795-4110
NPI assigned
Feb 21, 2006
Last updated
Sep 17, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2025

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

Authorized official

Name
James Dregney
Title
Cfo
Phone
(608) 643-7212

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU
Rural Health Clinic/Center 261QR1300X NU Primary

Addresses

Primary practice location

506 Crocker St Ste 3
Mazomanie, WI 53560-9426

Mailing address

506 Crocker St Ste 3
Mazomanie, WI 53560-9426
Phone (608) 795-4110

Other identifiers 2

IdentifierTypeStateIssuer
32764200MedicaidWI
CD3549OtherRAILROAD MEDICARE

Other names 1

  • WISCONSIN HEIGHTS CLINIC Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20031208000206 WI Part B Supplier - Clinic/Group Practice 8224948054 Receives reassigned benefits from 145 practitioners
13 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Lodi, WI; Mazomanie, WI; Plain, WI; Prairie Du Sac, WI; Sauk City, WI; Spring Green, WI
O20231023000837 WI Part A Provider - Rural Health Clinic 8224948054 Practice locations: Mazomanie, WI

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1073588299. Details of each certification follow.

Rural health clinic certification: CCN 528645

Legal name
SAUK PRAIRIE HEALTHCARE INC
Doing business as
WISCONSIN HEIGHTS CLINIC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Apr 6, 2023
Last certification
Apr 6, 2023
Ownership / control type
2B
Organization structure
CorporationNon-profit
Incorporated
Aug 17, 1954 in WI
Enrollment address
506 Crocker St
Ste 3
Mazomanie, WI 53560-9426
Related CCNs
520095

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 8

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

Other NPIs on the same Medicare enrollment 13

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 13

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
52D0392638Sauk Prairie Healthcare - Wisconsin Heights Clinic506 Crocker St, Mazomanie, WI 53560Certificate of waiverFeb 29, 2028

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 10

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

NameRoleSinceShare
James Dregney Individual Corporate OfficerCfo Jun 6, 2016
Corporate DirectorCfo Jun 6, 2016
W-2 Managing EmployeeCfo Jun 6, 2016
Kari Apel Individual Corporate OfficerBoard Member Apr 1, 2019
Corporate DirectorBoard Member Apr 1, 2019
Ryan Kraemer Individual Corporate OfficerBoard Member Apr 1, 2018
Corporate DirectorBoard Member Apr 1, 2018
Jeffrey Wright Individual Corporate OfficerBoard Member Apr 1, 2020
Corporate DirectorBoard Member Apr 1, 2020
Andrea Wyttenbach Gavot Individual Corporate OfficerBoard Member Apr 1, 2020
Corporate DirectorBoard Member Apr 1, 2020
Timothy Homar Individual Corporate OfficerBoard Member Apr 1, 2020
Corporate DirectorBoard Member Apr 1, 2020
Todd a Schad Individual Corporate OfficerBoard Member Apr 1, 2013
Corporate DirectorBoard Member Apr 1, 2013
Geofrrey Lorenz Individual Corporate OfficerBoard Member Apr 1, 2019
Corporate DirectorBoard Member Apr 1, 2019
Thomas Schwartz Individual Corporate OfficerBoard Member May 1, 2005
Corporate DirectorBoard Member May 1, 2005
Shawn Lerch Individual Corporate OfficerCeo Jun 26, 2017
Corporate DirectorCeo Jun 26, 2017
W-2 Managing EmployeeCeo Jun 26, 2017

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Practitioners 10

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": "1140480000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1758067200000",
    "number": "1073588299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "506 CROCKER ST STE 3",
            "city": "MAZOMANIE",
            "state": "WI",
            "postal_code": "535609426",
            "telephone_number": "608-795-4110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "506 CROCKER ST STE 3",
            "city": "MAZOMANIE",
            "state": "WI",
            "postal_code": "535609426",
            "telephone_number": "608-795-4110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAUK PRAIRIE HEALTHCARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-21",
        "last_updated": "2025-09-17",
        "certification_date": "2025-09-17",
        "status": "A",
        "authorized_official_last_name": "DREGNEY",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "608-643-7212"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32764200",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CD3549",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WISCONSIN HEIGHTS CLINIC",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "WISCONSIN HEIGHTS CLINIC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Mazomanie, WI

Sources for this page

Verify at the official NPI Registry.