NPIMap

Organization Active NPI

Mayo Clinic Health System-Southwest Wisconsin Region, Inc.

  • Rural Health Clinic/Center
  • Sparta, WI
National Provider Identifier
1366420788
Registry record updated Feb 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
MAYO CLINIC HEALTH SYSTEM-SOUTHWEST WISCONSIN REGION, INC.
Practice address
310 W Main St
Sparta, WI 54656-2170
Phone
(608) 269-1770
Fax
(608) 269-1017
NPI assigned
Jan 5, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2026

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

Authorized official

Name
Adam Smith
Title
Cfo
Phone
(715) 838-5275

Specialties & licenses 1

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

Addresses

Primary practice location

310 W Main St
Sparta, WI 54656-2170

Mailing address

PO Box 860056
Attn: Revenue Recognition & Compliance
Minneapolis, MN 55486-0056
Phone (608) 791-4156

Other names 3

  • Franciscan Healthcare - Sparta Doing business as
  • Mayo Clinic Health System-Sparta Doing business as
  • Mayo Clinic Health System-Franciscan Medical Center, Inc. Former legal business name

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Ability Network

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20031110000684 WI Part B Supplier - Clinic/Group Practice 0345152443 Receives reassigned benefits from 1,037 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: La Crosse, WI; Mondovi, WI; Onalaska, WI; Prairie Du Chien, WI; Sparta, WI; Tomah, WI; Arcadia, WI; Eau Claire, WI…
O20110125000911 WI Part A Provider - Rural Health Clinic 0345152443 Practice locations: Sparta, WI

Rural health clinic certification: CCN 523998

Legal name
MAYO CLINIC HEALTH SYSTEM-SOUTHWEST WISCONSIN REGION INC
Doing business as
MAYO CLINIC HEALTH SYSTEM - SPARTA
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Apr 14, 1997
Last certification
Nov 14, 2023
Ownership / control type
2B
Organization structure
CorporationNon-profit
Incorporated
Sep 26, 1883 in WI
Enrollment address
310 W Main St
Sparta, WI 54656-2170
Related CCNs
521305

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 2

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

National Provider Directory

National Provider Directory

Member of 1

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

Ownership & related parties

All disclosed owners & managing parties 16

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

NameRoleSinceShare
Matthew J Olmstead Individual Corporate DirectorBoard Member Jan 1, 2025
Paul Molling Individual Corporate DirectorBoard Member Mar 11, 2026
Franklin K Ackerman Individual Corporate OfficerSecretary Jan 1, 2025
Jason Beckermann Individual Corporate DirectorBoard Member Jan 1, 2025
Timothy J Young Individual Corporate DirectorBoard Member Jan 1, 2025
Richard a Helmers Individual Corporate OfficerCeo & Chair Mar 16, 2024
Corporate DirectorBoard Member Mar 16, 2024
Tanner T Holst Individual W-2 Managing EmployeeVice Chair Administration Oct 1, 2021
Lisa Gillette Individual Corporate DirectorBoard Member May 1, 2026
Charles W Nordstrom Individual Corporate DirectorBoard Member Jan 1, 2025
Kevin M Fitzgerald Individual Corporate DirectorBoard Member Jan 1, 2025
Gurpreet Singh Individual Corporate DirectorBoard Member Jan 1, 2025
Robert J Wiechmann Individual Corporate DirectorBoard Member Jan 1, 2025
Mayo Clinic Organization, Rochester, MN Non-profit Operational/Managerial Control Aug 24, 2010
Adam W Smith Individual Corporate OfficerCfo & Treasurer Jan 19, 2026
Corporate DirectorBoard Member Jan 19, 2026
Kelly M Buchholtz Individual Corporate DirectorBoard Member Jan 1, 2025
Janel N Glantz Individual Corporate DirectorBoard Member Jan 1, 2025

Owners & managing parties with NPI records 16

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

View all 16

Facilities with the same owner 38

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 38

Practitioners & affiliated clinicians

Practitioners 575

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

View all 575

NPI Registry JSON

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

{
    "created_epoch": "1136419200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1771977600000",
    "number": "1366420788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 860056",
            "address_2": "ATTN: REVENUE RECOGNITION & COMPLIANCE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554860056",
            "telephone_number": "608-791-4156",
            "fax_number": "608-392-9518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 W MAIN ST",
            "city": "SPARTA",
            "state": "WI",
            "postal_code": "546562170",
            "telephone_number": "608-269-1770",
            "fax_number": "608-269-1017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAYO CLINIC HEALTH SYSTEM-SOUTHWEST WISCONSIN REGION, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-05",
        "last_updated": "2026-02-25",
        "certification_date": "2026-02-25",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "ADAM",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "715-838-5275"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "Ability Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "64 S Price Rd SteB",
            "city": "Brownsville",
            "state": "TX",
            "country_code": "US",
            "postal_code": "785212459",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Franciscan Healthcare - Sparta",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Mayo Clinic Health System-Sparta",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Mayo Clinic Health System-Franciscan Medical Center, Inc.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Sparta, WI

Sources for this page

Verify at the official NPI Registry.