Winnebago Mental Health Institute

Primary specialty

Psychiatric HospitalTaxonomy code 283Q00000X

License

250 Issued in WI

Legal business name

WINNEBAGO MENTAL HEALTH INSTITUTE

Practice address

1300 South Drive
Winnebago, WI 54985-0009

Phone

(920) 235-4910

Fax

(920) 237-2043

NPI assigned

Oct 2, 2006

Last updated

Sep 10, 2026By the provider in NPPES

Organization subpart

Yes

Parent organization

STATE OF WISCONSINAs reported in NPPES

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

Authorized official

Name

Maria A Coonen

Title

Facility Director

Phone

(920) 235-4910

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Winnebago Mental Health Institute Other name

Medicare fee-for-service enrollment

Enrolled in WI2 enrollments

Enrollment records 2

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1164516506. Details of each certification follow.

• CCN 524002 Hospital · Active · Details

Hospital certification: CCN 524002

Legal name

STATE OF WISCONSIN

Doing business as

WINNEBAGO MENTAL HEALTH INSTITUTE

Certification status

Active

Provider type (POS)

Hospital – Psychiatric

Participating since

Jul 1, 1966

Last certification

Feb 28, 2018

Beds

315

Ownership / control type

State

Organization structure

GovernmentNon-profit

Enrollment address

4100 Treffert Drive
Winnebago, WI 54985-0009
Hospital Psychiatric Unit

Hospital subgroups

Psychiatric

Other NPIs with the same Medicare PAC ID 1

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

• State of Wisconsin

  • General Acute Care Hospital
  • Madison, WI
  • NPI 1437253648

  9234181751

  Same PAC ID

Other NPIs on the same Medicare enrollment 4

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

• State of Wisconsin

  dba Southern Wisconsin Center

  • Intellectual Disabilities Intermediate Care Facility
  • Union Grove, WI
  • NPI 1043326747

  O20050214000153

  Same enrollment
• State of Wisconsin

  dba Northern Wisconsin Center Excel

  • Intellectual Disabilities Intermediate Care Facility
  • Chippewa Falls, WI
  • NPI 1235225616

  O20050214000153

  Same enrollment
• State of Wisconsin

  dba Central Wisconsin Center for the Developmentally Disabled

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Madison, WI
  • NPI 1386705655

  O20050214000153

  Same enrollment
• State of Wisconsin

  • General Acute Care Hospital
  • Madison, WI
  • NPI 1437253648

  O20050214000153

  Same enrollment

Listed as

Winnebago Mental Health InstituteCCN 524002 · All quality measures

Type

Psychiatric

Ownership

Government - State

Medicare certification status

ActiveFrom the Provider of Services file

Emergency services

No

Part of

Winnebago Mental Health Institute

All disclosed owners & managing parties 2

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

Owners & managing parties with NPI records 1

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

• State of Wisconsin

  • General Acute Care Hospital
  • Madison, WI
  • NPI 1437253648

  5% Or Greater Direct Ownership Interest, Operational/Managerial Control

  CMS ownership

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• State of Wisconsin

  • General Acute Care Hospital
  • Madison, WI
  • NPI 1437253648

  Other

  CMS ownership

Practitioners 65

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.

• Candace Agress Cohen, M.D.

  • Psychiatry Physician
  • Sturgeon Bay, WI
  • NPI 1811927916
  NPD
• Ann Marie Heaslett, M.D.

  • Child & Adolescent Psychiatry Physician
  • Madison, WI
  • NPI 1467489484
  NPD
• Kristen L Knoepke, MD

  • Family Medicine Physician
  • Madison, WI
  • NPI 1710953740
  NPD
• Jeffrey Allen Marcus, M.D.

  • Psychiatry Physician
  • Chippewa Falls, WI
  • NPI 1821025677
  NPD
• Julie K Nielsen-Witkovsky, MD

  • Psychiatry Physician
  • Madison, WI
  • NPI 1518927813
  NPD
• Martha Leigh Rolli, MD

  • Psychiatry Physician
  • Monona, WI
  • NPI 1568438711
  NPD
• Aleksandar V Rosich, MD

  • Internal Medicine Physician
  • Milwaukee, WI
  • NPI 1972606028
  NPD
• Matthew S Sager, MD

  • Psychiatry Physician
  • Madison, WI
  • NPI 1215912936
  NPD
• Steven Tyska, MD

  • Family Medicine Physician
  • Madison, WI
  • NPI 1780645614
  NPD
• Robert J. Vickrey, M.D.

  • Psychiatry Physician
  • Milwaukee, WI
  • NPI 1659320331
  NPD
• Michael T Witkovsky, MD

  • Child & Adolescent Psychiatry Physician
  • Madison, WI
  • NPI 1629044797
  NPD
• Marklie Allen

  • Pharmacist
  • Oshkosh, WI
  • NPI 1447180443
  NPD (past)

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1788998400000",
    "number": "1164516506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9",
            "address_2": "1300 SOUTH DRIVE",
            "city": "WINNEBAGO",
            "state": "WI",
            "postal_code": "549850009",
            "telephone_number": "920-235-4910",
            "fax_number": "920-237-2043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 SOUTH DRIVE",
            "city": "WINNEBAGO",
            "state": "WI",
            "postal_code": "549850009",
            "telephone_number": "920-235-4910",
            "fax_number": "920-237-2043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WINNEBAGO MENTAL HEALTH INSTITUTE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "STATE OF WISCONSIN",
        "enumeration_date": "2006-10-02",
        "last_updated": "2026-09-10",
        "certification_date": "2026-09-10",
        "status": "A",
        "authorized_official_last_name": "COONEN",
        "authorized_official_first_name": "MARIA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "FACILITY DIRECTOR",
        "authorized_official_telephone_number": "920-235-4910"
    },
    "taxonomies": [
        {
            "code": "283Q00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Hospital",
            "state": "WI",
            "license": "250",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10063000",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Winnebago Mental Health Institute",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• John Edward Vickman, M.D
• Bruce E Weffenstette, M.D.
• Jared J West, MD
• Candace Whitman, APNP
• Winnebago County
• Wisconsin Resource Center
• Ranee Maree Wright, APNP
• Jofflyn Zaremba, APNP
• Carolyn Sue Zernzach, COTA
• Karin Zodrow

• Psychiatric Hospital in Winnebago, WI
• Providers in Winnebago, WI by specialty
• Psychiatric Hospital in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.