NPIMap

Organization Active NPI

Sauk Prairie Healthcare Inc

  • Rural Health Clinic/Center
  • Lodi, WI
National Provider Identifier
1225003445
Registry record updated Sep 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
SAUK PRAIRIE HEALTHCARE INC
Practice address
160 Valley Dr
Lodi, WI 53555-1464
Phone
(608) 592-3296
NPI assigned
Feb 21, 2006
Last updated
Sep 17, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2025

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

Authorized official

Name
James Dregney
Title
Cfo
Phone
(608) 643-7212

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

160 Valley Dr
Lodi, WI 53555-1464

Mailing address

160 Valley Dr
Lodi, WI 53555-1464

Other names 1

  • Lodi Medical Clinic Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20031208000206 WI Part B Supplier - Clinic/Group Practice 8224948054 Receives reassigned benefits from 145 practitioners
13 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Lodi, WI; Mazomanie, WI; Plain, WI; Prairie Du Sac, WI; Sauk City, WI; Spring Green, WI
O20120928000145 WI DME Supplier - Multi-Specialty - Physician 8224948054 Practice locations: Lodi, WI
O20171016002994 WI Part A Provider - Rural Health Clinic 8224948054 Practice locations: Lodi, WI

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1225003445. Details of each certification follow.

Rural health clinic certification: CCN 528586

Legal name
SAUK PRAIRIE HEALTHCARE INC
Doing business as
LODI CLINIC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Apr 18, 2018
Last certification
Apr 18, 2018
Ownership / control type
2B
Organization structure
CorporationNon-profit
Incorporated
Aug 17, 1954 in WI
Enrollment address
160 Valley Dr
Lodi, WI 53555-1464
Related CCNs
520095

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

Other NPIs with the same Medicare PAC ID 8

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

Other NPIs on the same Medicare enrollment 13

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

View all 13

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
52D0392940Sauk Prairie Healthcare - Lodi Clinic160 Valley Dr, Lodi, WI 53555AccreditationJul 28, 2027

National Provider Directory

National Provider Directory

Locations

1529 State St
Black Earth, WI 53515

506 Crocker St
Ste 3
Mazomanie, WI 53560
Phone (608) 795-4110

268 26TH St
Prairie Du Sac, WI 53578

Ownership & related parties

All disclosed owners & managing parties 13

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

NameRoleSinceShare
James Dregney Individual Corporate OfficerCfo Jun 30, 2017
Corporate DirectorCfo Jun 30, 2017
W-2 Managing EmployeeCfo Jun 30, 2017
Kari Apel Individual Corporate Director Apr 1, 2021
Ryan Kraemer Individual Corporate DirectorBoard Member Apr 1, 2018
Jeffrey Wright Individual Corporate DirectorBoard Member Apr 1, 2020
Brian Gorman Individual Corporate DirectorBoard Member Apr 1, 2021
Andrea Wyttenbach Gavot Individual Corporate Director Apr 1, 2020
Lea Culver Individual Corporate DirectorBoard Member Apr 1, 2021
Timothy Homar Individual Corporate DirectorBoard Member Apr 1, 2020
Ryan Vanriper Individual Corporate DirectorBoard Member Apr 1, 2021
Todd a Schad Individual Corporate OfficerBoard Member Apr 1, 2013
Corporate DirectorBoard Member Apr 1, 2013
Geofrrey Lorenz Individual Corporate Director Apr 1, 2019
Thomas Schwartz Individual Corporate OfficerBoard Member May 1, 2005
Corporate DirectorBoard Member May 1, 2005
Shawn Lerch Individual Corporate OfficerCeo Jun 26, 2017
Corporate DirectorCeo Jun 26, 2017

Owners & managing parties with NPI records 1

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

Practitioners & affiliated clinicians

Practitioners 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1140480000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1758067200000",
    "number": "1225003445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 VALLEY DR",
            "city": "LODI",
            "state": "WI",
            "postal_code": "535551464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 VALLEY DR",
            "city": "LODI",
            "state": "WI",
            "postal_code": "535551464",
            "telephone_number": "608-592-3296"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAUK PRAIRIE HEALTHCARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-21",
        "last_updated": "2025-09-17",
        "certification_date": "2025-09-17",
        "status": "A",
        "authorized_official_last_name": "DREGNEY",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "608-643-7212"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lodi Medical Clinic",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Lodi Medical Clinic",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Lodi, WI

Sources for this page

Verify at the official NPI Registry.