Southwest Health Center, Inc.
Organization Active NPI Medicare Defined Swing Bed Hospital Unit · Platteville, WI
NPI 1417032012 · NPPES record last updated Dec 17, 2021
Key facts
- NPI
- 1417032012
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Medicare Defined Swing Bed Hospital Unit 275N00000X
- License
- 1059 (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
- Organization subpart
- No
Authorized official
- Name
- Jesse Sookochoff
- Title
- Chief Financial Officer
- Phone
- (608) 348-2331
Owners & managing parties with NPI records 2
-
Kevin G Carr, MD
-
Joseph Robert Rosemeyer, D.C.
Owned or controlled facilities with NPI records 1
Other NPIs with the same Medicare PAC ID 6
Corporate family (same tax ID) 17
Related certifications (CCN) 1
Practitioners 112
-
Ashley Lorrie Adams, DPT
-
Jennifer Barraza, LCSW
-
Kori Barry, APNP
-
Catherine A Blume, APNP
-
Michelle Marie Brant, PA-C
-
Alexis Brown, CRNA
-
Christina S Burr, PA-C
-
Phillip O Burr, P.A.
-
Carmen M Campbell, M.D.
-
Kevin G Carr, MD
-
Elliot James Consigny, CRNA
-
Kelsey Dresen, RDN
-
Zachary Droeszler, M.D.
-
Allison Nicole Dunne, PA-C
-
Mary Elizabeth Gee, OTR/L
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
Hospital certification: CCN 52Z354
- Legal name
- SOUTHWEST HEALTH CENTER INC
- Organization structure
- Corporation · Non-profit
- Incorporated
- Jan 1, 1981 in WI
- Enrollment address
- 1400 Eastside Road
Platteville, WI 53818-9800
All disclosed owners & managing parties 11
| Name | Role | Since | Share |
|---|---|---|---|
| Angela M Udelhofen |
Corporate Director | Aug 1, 2014 | |
| Kevin G Carr |
Corporate Director | Feb 1, 2011 | |
| Lou Schweigert |
Corporate Director | Aug 1, 2011 | |
| Jesse Sookochoff |
Corporate Officer |
Oct 1, 2016 | |
| W-2 Managing Employee |
Oct 1, 2016 | ||
| Operational/Managerial Control |
Oct 1, 2016 | ||
| James Schneller |
Corporate Director | Aug 1, 2006 | |
| Sheila Simpson |
W-2 Managing Employee | Nov 1, 2013 | |
| Doug Rogers |
Corporate Director | Aug 1, 2007 | |
| Dan Rohrbach |
Corporate Officer |
Jan 1, 2013 | |
| W-2 Managing Employee |
Jan 1, 2013 | ||
| Operational/Managerial Control |
Jan 1, 2013 | ||
| Joseph R Rosemeyer |
Corporate Director | Jul 1, 2012 | |
| Donald Tuescher |
Corporate Director | Aug 1, 2015 | |
| Barbara a Karrmann |
Corporate Director | Jul 1, 2012 |
All facility ownership & control disclosures 1
| Facility | Type | Role | Since |
|---|---|---|---|
| St Dominic Villa |
Skilled nursing facility | 5% Or Greater Direct Ownership Interest (50%) | Jun 10, 2020 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20070524000315 | WI | Part a Provider - Critical Access Hospital | 3072427772 | Practice locations: Platteville, WI |
National Provider Directory
- Tax ID family
- Southwest HLTH Ctr Inc
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medicare Defined Swing Bed Hospital Unit | 275N00000X | 1059 | WI | Yes |
Addresses
Primary practice location
1400 Eastside Rd
Platteville, WI 53818-9800
Mailing address
1400 Eastside Rd
Platteville, WI 53818-9800
Phone (608) 348-2331
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 11000600 | Medicaid | WI |
Other providers in Platteville, WI
- Southwest Health Center Inc
- Southwest Health Center, Inc
- Southwest Health Center, Inc.
- Southwest Health Center, Inc.
- Southwest Health Center, Inc.
- Southwest Health Center, Inc.
- Southwest Health Center, Inc.
- Southwest Health Center, Inc.
- Southwest Health Center, Inc.
- Southwest Health Center, Inc.
All providers in Platteville, WI · Medicare Defined Swing Bed Hospital Unit in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 17, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.