NPIMap

Organization Active NPI

Southwest Health Center, Inc.

  • Medicare Defined Swing Bed Hospital Unit
  • Platteville, WI
National Provider Identifier
1417032012
Registry record updated Dec 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medicare Defined Swing Bed Hospital UnitTaxonomy code 275N00000X
License
1059 Issued in WI
Legal business name
SOUTHWEST HEALTH CENTER, INC.
Practice address
1400 Eastside Rd
Platteville, WI 53818-9800
Phone
(608) 348-2331
Fax
(608) 342-4713
NPI assigned
Oct 25, 2006
Last updated
Dec 17, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2021

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

Authorized official

Name
Jesse Sookochoff
Title
Chief Financial Officer
Phone
(608) 348-2331

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medicare Defined Swing Bed Hospital Unit 275N00000X 1059 WI Primary

Addresses

Primary practice location

1400 Eastside Rd
Platteville, WI 53818-9800

Mailing address

1400 Eastside Rd
Platteville, WI 53818-9800
Phone (608) 348-2331

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070524000315 WI Part A Provider - Critical Access Hospital 3072427772 Practice locations: Platteville, WI

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1417032012. Details of each certification follow.

Hospital certification: CCN 52Z354

Legal name
SOUTHWEST HEALTH CENTER INC
Organization structure
CorporationNon-profit
Incorporated
Jan 1, 1981 in WI
Enrollment address
1400 Eastside Road
Platteville, WI 53818-9800
Hospital Swing-Bed Unit

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

Other NPIs with the same Medicare PAC ID 6

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

National Provider Directory

National Provider Directory
Tax ID family
Southwest HLTH Ctr Inc18 organizations share this tax ID, including this one

Other organizations with this tax ID 17

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

View all 17

Ownership & related parties

All disclosed owners & managing parties 11

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

NameRoleSinceShare
Angela M Udelhofen Individual Corporate Director Aug 1, 2014
Kevin G Carr Individual Corporate Director Feb 1, 2011
Lou Schweigert Individual Corporate Director Aug 1, 2011
Jesse Sookochoff Individual Corporate OfficerCfo Oct 1, 2016
W-2 Managing EmployeeCfo Oct 1, 2016
Operational/Managerial ControlCfo Oct 1, 2016
James Schneller Individual Corporate Director Aug 1, 2006
Sheila Simpson Individual W-2 Managing Employee Nov 1, 2013
Doug Rogers Individual Corporate Director Aug 1, 2007
Dan Rohrbach Individual Corporate OfficerCeo/President Jan 1, 2013
W-2 Managing EmployeeCeo Jan 1, 2013
Operational/Managerial ControlCeo Jan 1, 2013
Joseph R Rosemeyer Individual Corporate Director Jul 1, 2012
Donald Tuescher Individual Corporate Director Aug 1, 2015
Barbara a Karrmann Individual Corporate Director Jul 1, 2012

Owners & managing parties with NPI records 2

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

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
St Dominic VillaHazel Green, WI, CCN 525660 Skilled nursing facility 5% Or Greater Direct Ownership Interest (50%) Jun 10, 2020

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 2

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": "1161734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1639699200000",
    "number": "1417032012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 EASTSIDE RD",
            "city": "PLATTEVILLE",
            "state": "WI",
            "postal_code": "538189800",
            "telephone_number": "608-348-2331",
            "fax_number": "608-342-4713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 EASTSIDE RD",
            "city": "PLATTEVILLE",
            "state": "WI",
            "postal_code": "538189800",
            "telephone_number": "608-348-2331",
            "fax_number": "608-342-4713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHWEST HEALTH CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-25",
        "last_updated": "2021-12-17",
        "certification_date": "2021-12-17",
        "status": "A",
        "authorized_official_last_name": "SOOKOCHOFF",
        "authorized_official_first_name": "JESSE",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "608-348-2331"
    },
    "taxonomies": [
        {
            "code": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": "WI",
            "license": "1059",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Platteville, WI

Sources for this page

Verify at the official NPI Registry.