Aspirus Ironwood Hospital & Clinics, Inc.

Organization Active NPI Rural Health Clinic/Center · Hurley, WI

NPI 1134547714 · NPPES record last updated Jun 7, 2024

Key facts

NPI
1134547714
Entity type
Organization (NPI type 2)
Primary specialty
Rural Health Clinic/Center 261QR1300X
Legal business name
ASPIRUS IRONWOOD HOSPITAL & CLINICS, INC.
Practice address
501 Granite St
Hurley, WI 54534-1372
Phone
(906) 561-2255
NPI assigned
Apr 1, 2014
Organization subpart
No

Authorized official

Name
Jerry M Hack
Title
SVP & Chief Financial Officer
Phone
(715) 847-2526

Owners & managing parties with NPI records 5

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

Other NPIs on the same Medicare enrollment 3

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

Corporate family (same tax ID) 10

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

Member of 2

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

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

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in WI

Rural health clinic certification: CCN 528560

Legal name
ASPIRUS IRONWOOD HOSPITAL & CLINICS INC
Doing business as
ASPIRUS HURLEY CLINIC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Dec 16, 2013
Last certification
Dec 16, 2013
Ownership / control type
2B
Organization structure
Corporation · Non-profit
Incorporated
Jun 25, 1991 in MI
Enrollment address
501 Granite St
Hurley, WI 54534-1372
Related CCNs
231333

All disclosed owners & managing parties 21

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 Director
Board Member/Vice Chair
Oct 1, 2019
Jerry M Yang
Individual
Corporate Director
SVP and Chief Financial Officer
Feb 26, 2024
W-2 Managing Employee
Ad;
Feb 26, 2024
Operational/Managerial Control
SVP and Chief Financial Officer
Feb 26, 2024
Kristen Meske
Individual
Corporate Director
Board Member
Oct 1, 2020
Paula Chermside
Individual
Corporate Director
Coo
Mar 1, 2013
W-2 Managing Employee
Coo
Jan 1, 2013
Aspirus, Inc
Organization · Wausau, WI
Corporation, Non-profit
5% Or Greater Direct Ownership Interest Jul 1, 2015 100%
Operational/Managerial Control Jul 1, 2015 100%
Robin L Meneguzzo
Individual
Corporate Director
Board Member
Oct 1, 2022
Daniel J Lukes
Individual
Corporate Director
Board Member
Oct 1, 2019
John Matonich
Individual
Corporate Director
Board Member
Oct 1, 2022
Katie Clark
Individual
Corporate Director
Board Member
Oct 21, 2019
James Richardson
Individual
Corporate Director
Board Member
Oct 1, 2021
Patrick Tincher
Individual
Corporate Director
Board Member
Oct 1, 2020
Richard Koubek
Individual
Corporate Director
Board Member
Oct 1, 2020
Jonathan N Brueggeman
Individual
Corporate Director
Board Member
Oct 21, 2019
Charly Loper
Individual
Corporate Director
Board Member
Oct 1, 2023
Lori Peck
Individual
Corporate Director
VP - Finance
Sep 30, 2015
W-2 Managing Employee
Ad;
Sep 30, 2015
Operational/Managerial Control
VP-Finance
Sep 30, 2015
Hannah Goodman
Individual
Corporate Director
Board Member
Oct 1, 2023
Kirk R Schott
Individual
Corporate Director
Board Member
Oct 21, 2019
Tyler Hack
Individual
Corporate Director
VP - Revenue Cycle
Feb 26, 2024
W-2 Managing Employee
Ad;
Feb 26, 2024
Operational/Managerial Control
VP - Revenue Cycle
Feb 26, 2024
John Pietila
Individual
Corporate Director
Board Member
Oct 1, 2022
Christine Harff
Individual
Corporate Director Jun 24, 2019
W-2 Managing Employee Oct 1, 2019
Operational/Managerial Control Oct 1, 2019
Matthew F Heywood
Individual
Corporate Director
Ceo
Jul 31, 2013

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20040206000462 WI Part B Supplier - Clinic/Group Practice 9032013198 Receives reassigned benefits from 3 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Hurley, WI
O20130114000062 WI Part a Provider - Rural Health Clinic 9032013198 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Hurley, WI

National Provider Directory

Tax ID family
Lewis C Tod MD (11 organizations share this tax ID)

Specialties & licenses

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

Addresses

Primary practice location

501 Granite St
Hurley, WI 54534-1372

Mailing address

29980 Network PL
Chicago, IL 60673-1299
Phone (906) 561-2255

Other names

  • Aspirus Hurley Clinic Doing business as
  • Aspirus Grand View Former legal business name

Other providers in Hurley, WI

All providers in Hurley, WI · Rural Health Clinic/Center in Wisconsin

Sources for this page

Verify at the official NPI Registry.