NPIMap

Organization Active NPI

Dickinson County Healthcare System

Doing business as Marshfield Medical Center - Dickinson Primary Care , RHC

  • Rural Health Clinic/Center
  • Iron Mountain, MI
National Provider Identifier
1083659502
Registry record updated Oct 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
DICKINSON COUNTY HEALTHCARE SYSTEM
Doing business as
Marshfield Medical Center - Dickinson Primary Care , RHC
Practice address
1711 S Stephenson Ave Ste 210
Iron Mountain, MI 49801-3649
Phone
(906) 776-5800
Fax
(906) 776-5801
NPI assigned
Jun 18, 2006
Last updated
Oct 21, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
MARSHFIELD CLINIC HEALTH SYSTEM INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 21, 2026

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

Authorized official

Name
Jolyn Munson
Title
VP Revenue Cycle Operations
Phone
(605) 328-6585

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

1711 S Stephenson Ave Ste 210
Iron Mountain, MI 49801-3649

Mailing address

1000 N Oak Ave
Attn: Provider Enrollment SVCS - SHP FL 2
Marshfield, WI 54449-5703
Phone (715) 898-6208

Other names 1

  • Marshfield Medical Center - Dickinson Primary Care , RHC Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Cobius Healthcare Solutions

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20040310000583 MI Part B Supplier - Clinic/Group Practice 6800784943 Receives reassigned benefits from 156 practitioners
27 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Skandia, MI; Novi, MI; Munising, MI; Marquette, MI; Kingsford, MI; Ishpeming, MI; Iron River, MI; Iron Mountain, MI…
O20050623000153 MI Part B Supplier - Clinic/Group Practice 6800784943 Receives reassigned benefits from 13 practitioners
23 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Iron Mountain, MI; Norway, MI; Marquette, MI; Kingsford, MI; Ishpeming, MI; Iron River, MI; Bark River, MI
O20101020000306 MI Part A Provider - Rural Health Clinic 6800784943 Practice locations: Iron Mountain, MI

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1083659502. Details of each certification follow.

Rural health clinic certification: CCN 238634

Legal name
DICKINSON COUNTY HEALTHCARE SYSTEM
Doing business as
MARSHFIELD MEDICAL CENTER - DICKINSON PRIMARY CARE
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Jun 29, 2011
Last certification
Jun 11, 2025
Ownership / control type
2B
Organization structure
CorporationNon-profit
Enrollment address
1711 S Stephenson Ave
Ste 210
Iron Mountain, MI 49801-3649
Related CCNs
230055

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

Other NPIs on the same Medicare enrollment 20

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

View all 20

National Provider Directory

National Provider Directory
Part of
Marshfield Clinic Health System Inc

Member of 1

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

  • MCHS Hospitals Inc

    dba MCHS Freestanding Clinic Physician Group

    • Internal Medicine Physician
    • Wausau, WI
    • NPI 1164159109

    Member Of

    NPD member

Locations

1711 S Stephenson Ave
Ste 210
Iron Mountain, MI 49801
Phone (906) 776-5800

Ownership & related parties

All disclosed owners & managing parties 15

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

NameRoleSinceShare
Brian D Hoerneman Individual Corporate OfficerPresident, Ceo Apr 5, 2023
Corporate DirectorBoard Member Sep 2, 2023
Tony Lee Morrison Individual W-2 Managing EmployeeVP, Chief Revenue Officer Jan 1, 2025
John F Baltus Individual Corporate OfficerTreasurer, Secretary, Vice Chair Sep 8, 2023
Corporate DirectorBoard Member Sep 9, 2023
Jolyn Joy Munson Individual W-2 Managing EmployeeVP Revenue Cycle Operations Jan 1, 2025
Dennis H Smith Individual Corporate DirectorBoard Member Jan 14, 2025
Jeffrey Douglas Poppen Individual Corporate OfficerCfo - Marshfield Jun 12, 2025
W-2 Managing EmployeeCfo - Marshfield Jun 12, 2025
Edward G Fernandez Individual Corporate OfficerChair Jan 1, 2025
Corporate DirectorBoard Member Sep 9, 2023
MCHS Hospitals Inc Organization, Marshfield, WI Corporation, Non-profit 5% Or Greater Direct Ownership Interest Feb 3, 2022 100%
Samantha L Klebe Individual Corporate DirectorBoard Member Sep 9, 2023
W-2 Managing EmployeeChief Physician Jan 1, 2025
Linda Laverne Procci Individual Corporate DirectorBoard Member Feb 1, 2025
Sanford Organization, Fargo, ND Corporation, Non-profit, Chain home office 5% Or Greater Indirect Ownership Interest Jan 1, 2025 100%
Everett W Newcomb Individual Corporate DirectorBoard Member Sep 13, 2024
Marshfield Clinic Health System Inc Organization, Marshfield, WI Non-profit 5% Or Greater Indirect Ownership Interest Feb 3, 2022 100%
Douglas Mathison Individual Corporate DirectorBoard Member Dec 15, 2020
Nicholas Wayne Olson Individual W-2 Managing EmployeeCfo - Sanford, Executive VP Jan 1, 2025

Owners & managing parties with NPI records 3

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

Facilities with the same owner 41

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 41

NPI Registry JSON

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

{
    "created_epoch": "1150588800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1792540800000",
    "number": "1083659502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 N OAK AVE",
            "address_2": "ATTN: PROVIDER ENROLLMENT SVCS - SHP FL 2",
            "city": "MARSHFIELD",
            "state": "WI",
            "postal_code": "544495703",
            "telephone_number": "715-898-6208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1711 S STEPHENSON AVE STE 210",
            "city": "IRON MOUNTAIN",
            "state": "MI",
            "postal_code": "498013649",
            "telephone_number": "906-776-5800",
            "fax_number": "906-776-5801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DICKINSON COUNTY HEALTHCARE SYSTEM",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MARSHFIELD CLINIC HEALTH SYSTEM INC",
        "enumeration_date": "2006-06-18",
        "last_updated": "2026-10-21",
        "certification_date": "2026-10-21",
        "status": "A",
        "authorized_official_last_name": "MUNSON",
        "authorized_official_first_name": "JOLYN",
        "authorized_official_title_or_position": "VP REVENUE CYCLE OPERATIONS",
        "authorized_official_telephone_number": "605-328-6585"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1068.1",
            "affiliationName": "Cobius Healthcare Solutions",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "2720 Dundee Rd # 302",
            "city": "Northbrook",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600622609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Marshfield Medical Center - Dickinson Primary Care , RHC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Iron Mountain, MI

Sources for this page

Verify at the official NPI Registry.