NPIMap

Organization Active NPI

Aspirus Rhinelander & Tomahawk Hospitals & Clinics, Inc.

Doing business as Aspirus Crandon Clinic

  • General Practice Physician
  • Crandon, WI
National Provider Identifier
1386267664
Registry record updated Jun 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
ASPIRUS RHINELANDER & TOMAHAWK HOSPITALS & CLINICS, INC.
Doing business as
Aspirus Crandon Clinic
Practice address
400 W Glen St
Crandon, WI 54520-1355
Phone
(715) 478-3318
NPI assigned
May 21, 2020
Last updated
Jun 10, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2024

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

Authorized official

Name
Jerry M Yang
Title
SVP & Chief Financial Officer
Phone
(715) 847-2526

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
Rehabilitation Clinic/Center 261QR0400X
General Practice Physician 208D00000X Primary

Addresses

Primary practice location

400 W Glen St
Crandon, WI 54520-1355

Mailing address

400 W Glen St
Crandon, WI 54520-1355
Phone (715) 478-3318

Other names 1

  • Aspirus Crandon Clinic Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Sacred Heart St Marys H15 organizations share this tax ID, including this one

Other organizations with this tax ID 14

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

View all 14

Locations

400 W Glen St
Crandon, WI 54520
Phone (715) 478-3318

NPI Registry JSON

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

{
    "created_epoch": "1590019200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717977600000",
    "number": "1386267664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 W GLEN ST",
            "city": "CRANDON",
            "state": "WI",
            "postal_code": "545201355",
            "telephone_number": "715-478-3318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 W GLEN ST",
            "city": "CRANDON",
            "state": "WI",
            "postal_code": "545201355",
            "telephone_number": "715-478-3318"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASPIRUS RHINELANDER & TOMAHAWK HOSPITALS & CLINICS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-21",
        "last_updated": "2024-06-10",
        "certification_date": "2024-06-10",
        "status": "A",
        "authorized_official_last_name": "YANG",
        "authorized_official_first_name": "JERRY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "SVP & CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "715-847-2526"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Aspirus Crandon Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Crandon, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.