NPIMap

Sauk Prairie Healthcare Inc

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

NPI 1225003445 · NPPES record last updated Sep 17, 2025

Key facts

NPI
1225003445
Entity type
Organization (NPI type 2)
Primary specialty
Rural Health Clinic/Center 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
Organization subpart
No

Authorized official

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

Owners & managing parties with NPI records 1

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

  • Todd A Schad, M.D. Obstetrics & Gynecology Physician · Sauk City, WI · NPI 1285732818
    CMS ownership CORPORATE DIRECTOR · CORPORATE OFFICER

Other NPIs on the same Medicare enrollment 13

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

Other NPIs with the same Medicare PAC ID 8

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

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

Practitioners 124

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 124

Laboratory certificates & supplier records

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

CLIA laboratory certificates

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

Medicare participation

Medicare fee-for-service enrollment
Enrolled (3 enrollments) in WI

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
Corporation · Non-profit
Incorporated
Aug 17, 1954 in WI
Enrollment address
160 Valley Dr
Lodi, WI 53555-1464
Related CCNs
520095

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 Officer
Cfo		 Jun 30, 2017
Corporate Director
Cfo		 Jun 30, 2017
W-2 Managing Employee
Cfo		 Jun 30, 2017
Kari Apel
Individual 		Corporate Director Apr 1, 2021
Ryan Kraemer
Individual 		Corporate Director
Board Member		 Apr 1, 2018
Jeffrey Wright
Individual 		Corporate Director
Board Member		 Apr 1, 2020
Brian Gorman
Individual 		Corporate Director
Board Member		 Apr 1, 2021
Andrea Wyttenbach Gavot
Individual 		Corporate Director Apr 1, 2020
Lea Culver
Individual 		Corporate Director
Board Member		 Apr 1, 2021
Timothy Homar
Individual 		Corporate Director
Board Member		 Apr 1, 2020
Ryan Vanriper
Individual 		Corporate Director
Board Member		 Apr 1, 2021
Todd a Schad
Individual 		Corporate Officer
Board Member		 Apr 1, 2013
Corporate Director
Board Member		 Apr 1, 2013
Geofrrey Lorenz
Individual 		Corporate Director Apr 1, 2019
Thomas Schwartz
Individual 		Corporate Officer
Board Member		 May 1, 2005
Corporate Director
Board Member		 May 1, 2005
Shawn Lerch
Individual 		Corporate Officer
Ceo		 Jun 26, 2017
Corporate Director
Ceo		 Jun 26, 2017

Medicare enrollment records

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

National Provider Directory

Locations

1529 State St
Black Earth, WI 53515

506 Crocker St
Mazomanie, WI 53560
Phone (608) 795-4820

268 26TH St
Prairie Du Sac, WI 53578

Specialties & licenses

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

Addresses

Primary practice location

160 Valley Dr
Lodi, WI 53555-1464

Mailing address

160 Valley Dr
Lodi, WI 53555-1464

Other identifiers

IdentifierTypeStateIssuer
CI6108OtherRAILROAD MEDICARE
32764200MedicaidWI

Other names

  • Lodi Medical Clinic Other name

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Sep 17, 2025.

{
    "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": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CI6108",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32764200",
            "state": "WI"
        }
    ],
    "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

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

Sources for this page

Verify at the official NPI Registry.