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Organization Active NPI

Divine Savior Healthcare, Inc.

Doing business as Aspirus Divine Savior Hospital

  • General Acute Care Hospital
  • Portage, WI
National Provider Identifier
1124083894
Registry record updated Jul 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
Legal business name
DIVINE SAVIOR HEALTHCARE, INC.
Doing business as
Aspirus Divine Savior Hospital
Aspirus Oxford Clinic
Aspirus Pardeeville Clinic1 more in Other names
Practice address
2817 New Pinery Rd
Portage, WI 53901-9240
Phone
(608) 742-4131
Fax
(608) 742-6098
NPI assigned
Apr 18, 2006
Last updated
Jul 24, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2026

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

Authorized official

Name
Mrs. Lori Peck
Title
SVP- Chief Financial Officer
Phone
(715) 847-2575

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X NU
Family Medicine Physician 207Q00000X NU
Physical Therapy Clinic/Center 261QP2000X NU
General Acute Care Hospital 282N00000X 3729800 WI
General Acute Care Hospital 282N00000X NU Primary

Addresses

Primary practice location

2817 New Pinery Rd
Portage, WI 53901-9240

Mailing address

29980 Network PL
Chicago, IL 60673-1299
Phone (608) 742-4131

Other practice location 1

N4390 Crossroads Clinic Rd
Oxford, WI 53952-9465
Phone (608) 589-5333

Other practice location 2

102 Gillette St
Pardeeville, WI 53954-9317
Phone (608) 429-2185

Other identifiers 17

IdentifierTypeStateIssuer
1144203381OtherWIINDIVIDUAL PHYSICIAN NPI
1376527002OtherWIINDIVIDUAL PHYSICIAN NPI
1659589653OtherWIINDIVIDUAL PHYSICIAN NPI
1881677011OtherWIINDIVIDUAL PHYSICIAN NPI
1689657827OtherWIINDIVIDUAL PHYSICIAN NPI
1699959593OtherWIINDIVIDUAL PHYSICIAN NPI
11009500MedicaidWI
1457334468OtherWIINDIVIDUAL PHYSICIAN NPI
1537142765OtherWIINDIVIDUAL PHYSICIAN NPI
1619966058OtherWIINDIVIDUAL PHYSICIAN NPI
1871576017OtherWIINDIVIDUAL PHYSICIAN NPI
1023054137OtherWIINDIVIDUAL PHYSICIAN NPI
1336122506OtherWIINDIVIDUAL PHYSICIAN NPI
1437132669OtherWVINDIVIDUAL PHYSICIAN NPI
1497738637OtherWIINDIVIDUAL PHYSICIAN NPI
1073596235OtherWIINDIVIDUAL PHYSICIAN NPI
1174508261OtherWIINDIVIDUAL PHYSICIAN NPI

Other names 4

  • Aspirus Divine Savior Hospital Doing business as
  • Aspirus Oxford Clinic Doing business as
  • Aspirus Pardeeville Clinic Doing business as
  • Aspirus Portage Clinic Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040106000557 WI Part A Provider - Hospital 5799684007 Practice locations: Oxford, WI; Portage, WI
O20040225000909 WI Part B Supplier - Clinic/Group Practice 5799684007 Receives reassigned benefits from 394 practitioners
Practice locations: Oxford, WI; Pardeeville, WI; Portage, WI

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1124083894. Details of each certification follow.

Hospital certification: CCN 520041

Legal name
DIVINE SAVIOR HEALTHCARE INC
Doing business as
ASPIRUS DIVINE SAVIOR HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Feb 11, 2011
Beds
73
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Incorporated
Dec 16, 1999 in WI
Enrollment address
2817 New Pinery Rd
Portage, WI 53901-9240
Other Hospital Practice Location
Hospital subgroups
Acute care, Swing-bed approved

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

Other NPIs with the same Medicare PAC ID 3

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Aspirus Divine Savior HospitalCCN 520041 · All quality measures
Overall star rating
3 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory

Locations

N4390 Crossroads Clinic Rd
Oxford, WI 53952
Phone (608) 589-5181

Ownership & related parties

All disclosed owners & managing parties 18

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

NameRoleSinceShare
Jennifer Redman-Schell Individual Corporate DirectorBoard Member Apr 21, 2022
Michael Holzhueter Individual W-2 Managing Employee Oct 1, 2019
Jerry M Yang Individual Corporate DirectorSVP and Chief Financial Officer Feb 26, 2024
W-2 Managing EmployeeSVP and Chief Financial Offic Feb 26, 2024
Operational/Managerial ControlSVP and Chief Financial Officer Feb 26, 2024
Justin Huebner Individual Corporate DirectorBoard Member Apr 21, 2022
Joshua Pogorelec Individual Corporate DirectorBoard Member Jan 31, 2020
Michael Bovee Individual Corporate DirectorBoard Member Oct 1, 2014
Susan Kreckman Individual Corporate DirectorBoard Member Jan 31, 2020
Aspirus, Inc Organization, Wausau, WI Non-profit 5% Or Greater Direct Ownership Interest Jan 31, 2020 100%
Operational/Managerial Control Jan 31, 2020 100%
Lynn Vogt Individual Corporate Director Feb 4, 2020
Trina Daniels Individual Corporate DirectorBoard Member Sep 30, 2023
Mary Ironside Individual Corporate DirectorBoard Member May 18, 2017
Daniel Burns Individual Corporate DirectorBoard Member Sep 30, 2021
Craig Broeren Individual Corporate DirectorBoard Member Sep 30, 2021
Lori Peck Individual Corporate DirectorVP - Finance Dec 1, 2021
W-2 Managing EmployeeVP-Finance Dec 1, 2021
Operational/Managerial ControlVP-Finance Dec 1, 2021
Tyler Hack Individual Corporate DirectorVP - Revenue Cycle Feb 26, 2024
W-2 Managing EmployeeVP - Revenue Cycle Feb 26, 2024
Operational/Managerial ControlVP - Revenue Cycle Feb 26, 2024
Bonita Kolrud Individual Corporate DirectorBoard Member Sep 30, 2018
Matthew F Heywood Individual Corporate OfficerCeo Jul 31, 2013
W-2 Managing EmployeeCeo Jul 31, 2013
Operational/Managerial ControlCeo Jul 31, 2013
Rebecca Sommer Individual Corporate DirectorBoard Member Sep 30, 2021

Owners & managing parties with NPI records 4

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

Facilities with the same owner 79

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

View all 79

Practitioners & affiliated clinicians

Practitioners 396

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.

View all 396

Affiliated clinicians 178

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 178

NPI Registry JSON

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

{
    "created_epoch": "1145318400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1784851200000",
    "number": "1124083894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29980 NETWORK PL",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606731299",
            "telephone_number": "608-742-4131",
            "fax_number": "608-742-6098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2817 NEW PINERY RD",
            "city": "PORTAGE",
            "state": "WI",
            "postal_code": "539019240",
            "telephone_number": "608-742-4131",
            "fax_number": "608-742-6098"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "N4390 Crossroads Clinic Rd",
            "address_purpose": "LOCATION",
            "city": "Oxford",
            "state": "WI",
            "postal_code": "539529465",
            "country_code": "US",
            "telephone_number": "608-589-5333",
            "fax_number": "608-589-5388",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "102 Gillette St",
            "address_purpose": "LOCATION",
            "city": "Pardeeville",
            "state": "WI",
            "postal_code": "539549317",
            "country_code": "US",
            "telephone_number": "608-429-2185",
            "fax_number": "608-742-6098",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "DIVINE SAVIOR HEALTHCARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-18",
        "last_updated": "2026-07-24",
        "certification_date": "2026-07-24",
        "status": "A",
        "authorized_official_last_name": "PECK",
        "authorized_official_first_name": "LORI",
        "authorized_official_title_or_position": "SVP- CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "715-847-2575",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "WI",
            "license": "3729800",
            "primary": false
        },
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
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            "identifier": "1881677011",
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        },
        {
            "code": "01",
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        },
        {
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    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Aspirus Divine Savior Hospital",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Aspirus Divine Savior Hospital",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Aspirus Oxford Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Aspirus Pardeeville Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Aspirus Portage Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Portage, WI

Sources for this page

Verify at the official NPI Registry.