Aspirus Keweenaw
Organization Active NPI Pharmacy · Ontonagon, MI
NPI 1104516376 · NPPES record last updated Feb 26, 2026
Key facts
- NPI
- 1104516376
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Pharmacy 333600000X
- Legal business name
- ASPIRUS KEWEENAW
- Practice address
- 601 S 7TH St
Ontonagon, MI 49953-1448 - Phone
- (906) 884-8000
- NPI assigned
- May 11, 2023
- Organization subpart
- No
Authorized official
- Name
- Lori Peck
- Title
- SVP- Chief Financial Officer
- Phone
- (715) 847-2575
Owners & managing parties with NPI records 5
-
Kristen Meske, AGPCNP
-
John Pietila, M.D.
-
Kirk Robert Schott, O.D.
-
Daniel John Lukes, D.O.
Other NPIs on the same Medicare enrollment 2
Other NPIs with the same Medicare PAC ID 6
Corporate family (same tax ID) 1
Related certifications (CCN) 5
Practitioners 129
-
Richard John Raffaelli, PA-C
-
Navjit Dullet, DO
-
Amir Fallahian, MD
-
Patricio G Rossi, M.D.
-
Zainab Almahrous, MD
-
Terry Marie Anderson, SLP
-
Todd W Anderson, DO
-
Tatyana G Bombard, D.O
-
Mark Philip Brown, PA-C
-
Kasey J. Burke, FNP-C
-
Derek Bustos, P.T.
-
Meredith Caudill, FNP-C
-
Jessica Caulkins, FNP-C
-
Toni M Clisch, NP-C
-
Sandra L. Coppo, MSW
-
Jasmin J David, CRNA
-
Marilynn S. Dewald, M.D.
-
Helen Domitrovich, APRN, DNP, FNP-C
-
Beau Dupuis, PT, DPT, CSCS
Affiliated clinicians 103
-
Zainab Almahrous, MD
-
Tatyana G Bombard, D.O
-
Austin Bramwell, MD
-
Mark Philip Brown, PA-C
-
Kasey J. Burke, FNP-C
-
Toni M Clisch, NP-C
-
Alycia Davidson, FNP-C
-
John P Deveau, DO
-
Marilynn S. Dewald, M.D.
-
Meghan Nicole Digneit, FNP-C
-
Helen Domitrovich, APRN, DNP, FNP-C
-
Adam Girard Frimodig, D.O.
-
Deborah K Gruver, FNP
-
Bonnie L Hafeman, M.D.
-
Shannon I Handler, NP-C
-
Jennifer Lynn Huls, NP-C
Medicare Care Compare: Hospital
- Listed as
- Aspirus Keweenaw Hospital and Clinics
- Type
- Critical Access Hospitals
- Ownership
- Voluntary non-profit - Private
- Medicare certification status
- Active
- Emergency services
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in MI
Hospital certification: CCN 231319
- Legal name
- ASPIRUS KEWEENAW
- Doing business as
- ASPIRUS KEWEENAW HOSPITAL
- Certification status
- Active
- Provider type (POS)
- Hospital – Critical access hospital
- Participating since
- Aug 1, 2004
- Last certification
- Jul 16, 2004
- Beds
- 25
- Ownership / control type
- Private (not for profit)
- Organization structure
- Corporation · Non-profit
- Enrollment address
- 205 Osceola St
Laurium, MI 49913-2134
All disclosed owners & managing parties 19
| Name | Role | Since | Share |
|---|---|---|---|
| Jennifer Redman-Schell |
Corporate Officer |
Oct 1, 2019 | |
| Corporate Director |
Oct 1, 2019 | ||
| Jerry M Yang |
Corporate Officer |
Feb 26, 2023 | |
| Corporate Director |
Feb 26, 2024 | ||
| W-2 Managing Employee |
Feb 26, 2024 | ||
| Operational/Managerial Control |
Feb 26, 2024 | ||
| Kristen Meske |
Corporate Director |
Oct 1, 2020 | |
| Matthew Krause |
W-2 Managing Employee |
Jan 1, 2022 | |
| Operational/Managerial Control |
Jan 1, 2022 | ||
| Aspirus, Inc |
5% Or Greater Direct Ownership Interest | Aug 1, 2008 | 100% |
| Robin L Meneguzzo |
Corporate Director |
Oct 1, 2022 | |
| Daniel J Lukes |
Corporate Director |
Oct 1, 2019 | |
| John Matonich |
Corporate Director |
Oct 1, 2022 | |
| Katie Clark |
Corporate Director |
Oct 21, 2019 | |
| James Richardson |
Corporate Director |
Oct 1, 2021 | |
| Patrick Tincher |
Corporate Director |
Oct 1, 2020 | |
| Richard Koubek |
Corporate Director |
Oct 1, 2020 | |
| Jonathan N Brueggeman |
Corporate Director |
Oct 21, 2019 | |
| Lori Peck |
Corporate Director |
Sep 30, 2015 | |
| W-2 Managing Employee |
Sep 30, 2015 | ||
| Operational/Managerial Control |
Sep 30, 2015 | ||
| Kirk R Schott |
Corporate Director |
Oct 21, 2019 | |
| Tyler Hack |
Corporate Officer |
Feb 26, 2024 | |
| Corporate Director |
Feb 26, 2024 | ||
| W-2 Managing Employee |
Feb 26, 2024 | ||
| Operational/Managerial Control |
Feb 26, 2024 | ||
| John Pietila |
Corporate Director |
Oct 1, 2022 | |
| Christine Harff |
Corporate Director |
Oct 1, 2019 | |
| Matthew F Heywood |
Corporate Director |
Jan 1, 2014 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20080123000612 | MI | Part a Provider - Critical Access Hospital | 8123912011 |
Receives reassigned benefits from 182 practitioners 2 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Houghton, MI; Laurium, MI; Ontonagon, MI |
| O20240402000585 | MI | Part B Supplier - Pharmacy | 8123912011 | Practice locations: Ontonagon, MI |
National Provider Directory
- Tax ID family
- Aspirus Bruce Crossing Clinic
Locations
601 S 7th St
Rm 5
Ontonagon, MI 49953
Phone (906) 884-8140
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | Yes |
Addresses
Primary practice location
601 S 7TH St
Ontonagon, MI 49953-1448
Mailing address
29980 Network PL
Chicago, IL 60673-1299
Phone (715) 847-2304
Other names
- Aspirus Pharmacy - Ontonagon
Other providers in Ontonagon, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 26, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.