NPIMap

Organization Active NPI

Tomah Memorial Hospital Inc

Doing business as Tomah Health

  • Critical Access Hospital
  • Tomah, WI
National Provider Identifier
1184765240
Registry record updated Mar 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
License
2049-800 Issued in WI
Legal business name
TOMAH MEMORIAL HOSPITAL INC
Doing business as
Tomah Health
Tomah Memorial Hospital
Practice address
501 Gopher Dr
Tomah, WI 54660-4513
Phone
(608) 372-2181
Fax
(608) 377-8737
NPI assigned
Feb 10, 2007
Last updated
Mar 28, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2025

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

Authorized official

Name
Mr. Joseph Zeps
Title
Cfo
Phone
(608) 372-2181

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X NU
Critical Access Hospital 282NC0060X 2049-800 WI Primary

Addresses

Primary practice location

501 Gopher Dr
Tomah, WI 54660-4513

Mailing address

501 Gopher Dr
Tomah, WI 54660-4513
Phone (608) 372-2181

Other practice location 1

101 Unity Dr
Warrens, WI 54666-6618
Phone (608) 372-2181

Other identifiers 1

IdentifierTypeStateIssuer
11017810MedicaidWI

Other names 2

  • TOMAH HEALTH Doing business as
  • Tomah Memorial Hospital Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101120000172 WI Part A Provider - Critical Access Hospital 6901897016 Receives reassigned benefits from 193 practitioners
Practice locations: Tomah, WI

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1184765240. Details of each certification follow.

Hospital certification: CCN 521320

Legal name
TOMAH MEMORIAL HOSPITAL INC
Doing business as
TOMAH MEMORIAL HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Apr 1, 2002
Last certification
Nov 15, 2012
Beds
15
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Incorporated
Oct 25, 1948 in WI
Enrollment address
501 Gopher Drive
Tomah, WI 54660
Other Hospital Practice Location

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
Tomah Memorial HospitalCCN 521320 · All quality measures
Overall star rating
5 of 5
Type
Critical Access Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory
Tax ID family
Tomah Memorial Hosp7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

Locations

101 Unity Dr
Warrens, WI 54666
Phone (608) 372-2181

Ownership & related parties

All disclosed owners & managing parties 14

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

NameRoleSinceShare
Jeffrey S Cavaness Individual Corporate DirectorBoard Member Jan 19, 2021
Robert Holness Individual Corporate OfficerBoard Member Jan 18, 2022
John W Robertson Individual Corporate DirectorBoard Member Jan 1, 2016
Greg Gaarder Individual Other Jan 10, 2019
Sue Playter Mubarak Individual Other Jan 18, 2022
Deb Buswell Individual Corporate DirectorBoard Member Jan 19, 2021
Tracy Myhre Individual W-2 Managing Employee Oct 27, 2009
Penny Precour-Berry Individual Corporate DirectorBoard Member Jan 1, 2017
John Laufenberg Individual Corporate DirectorBoard Member Jan 1, 2017
Spencer Stephens Individual Corporate DirectorBoard Member Jan 1, 2017
Brian Scott Nicol Individual Corporate DirectorBoard Member Jan 18, 2022
Derek Daly Individual Contracted Managing EmployeeCeo Aug 1, 2022
Corporate Director Aug 1, 2022
Keith Laugen Individual Other Jan 10, 2019
Joseph P Zeps Individual Corporate OfficerCfo Mar 28, 2006
W-2 Managing Employee Mar 28, 2006

Owners & managing parties with NPI records 3

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

Subparts reporting this organization as parent 7

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 199

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 199

Affiliated clinicians 168

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

View all 168

NPI Registry JSON

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

{
    "created_epoch": "1171065600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1743120000000",
    "number": "1184765240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 GOPHER DR",
            "city": "TOMAH",
            "state": "WI",
            "postal_code": "546604513",
            "telephone_number": "608-372-2181",
            "fax_number": "608-377-8637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 GOPHER DR",
            "city": "TOMAH",
            "state": "WI",
            "postal_code": "546604513",
            "telephone_number": "608-372-2181",
            "fax_number": "608-377-8737"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "101 Unity Dr",
            "address_purpose": "LOCATION",
            "city": "Warrens",
            "state": "WI",
            "postal_code": "546666618",
            "country_code": "US",
            "telephone_number": "608-372-2181",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "TOMAH MEMORIAL HOSPITAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-10",
        "last_updated": "2025-03-28",
        "certification_date": "2025-03-28",
        "status": "A",
        "authorized_official_last_name": "ZEPS",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "608-372-2181",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "WI",
            "license": "2049-800",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "11017810",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "TOMAH HEALTH",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Tomah Memorial Hospital",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Tomah Memorial Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tomah, WI

Sources for this page

Verify at the official NPI Registry.