NPIMap

Organization Active NPI

Memorial Medical Center Inc

Doing business as Tamarack Health Ashland Medical Center

  • Critical Access Hospital
  • Ashland, WI
National Provider Identifier
1437179231
Registry record updated Nov 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
License
1065 Issued in WI
Legal business name
MEMORIAL MEDICAL CENTER INC
Doing business as
Tamarack Health Ashland Medical Center
Practice address
1615 Maple LN
Ashland, WI 54806-3610
Phone
(715) 685-5500
Fax
(715) 685-5118
NPI assigned
Jul 21, 2006
Last updated
Nov 22, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2023

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

Authorized official

Name
Mr. Jason T Douglas
Title
President
Phone
(715) 685-5512

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Hospital Unit 273R00000X 1066 WI
Critical Access Hospital 282NC0060X 1065 WI Primary

Addresses

Primary practice location

1615 Maple LN
Ashland, WI 54806-3610

Mailing address

1615 Maple LN
Ashland, WI 54806-3610
Phone (715) 685-5500

Other identifiers 12

IdentifierTypeStateIssuer
00001048MedicaidWI
301555922MedicaidMI
0160JMEOtherMNBCBS BEH HEALTH INPT
099847800MedicaidMN
11019510OtherWIMEDICAID - CAH
405172492MedicaidMI
32947500MedicaidWI
36585MEOtherMNBCBS PROF COMPONENTS
11019521MedicaidWI
11019526MedicaidWI
32769900MedicaidWI
11019500MedicaidWI

Other names 1

  • Tamarack Health Ashland Medical Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20040402000938 WI Part B Supplier - Clinic/Group Practice 8022000447 Receives reassigned benefits from 181 practitioners
Practice locations: Ashland, WI; Hayward, WI; Spooner, WI; Superior, WI
O20070625000370 WI Part A Provider - Critical Access Hospital 8022000447 Receives reassigned benefits from 143 practitioners
Practice locations: Ashland, WI
O20200825001259 WI DME Supplier - Hospital 8022000447 Practice locations: Ashland, WI

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1437179231. Details of each certification follow.

Hospital certification: CCN 521359

Legal name
MEMORIAL MEDICAL CENTER INC
Doing business as
TAMARACK HEALTH ASHLAND MEDICAL CENTER
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Oct 1, 2007
Last certification
Mar 27, 2020
Beds
25
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Enrollment address
1615 Maple LN
Ashland, WI 54806-3626
Main/Primary Hospital Location

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

Other NPIs with the same Medicare PAC ID 2

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Tamarack Health Ashland Medical CenterCCN 521359 · All quality measures
Overall star rating
3 of 5
Type
Critical Access Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 17

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

NameRoleSinceShare
Thomas Jokinen Individual Corporate DirectorBoard Member Jun 7, 2007
Christine Iverson Individual Corporate DirectorBoard Member Jun 7, 2007
Dani Mikula Individual Corporate DirectorBoard Member Feb 21, 2024
Patricia Schraufnagel Individual Corporate DirectorBoard Member Jun 7, 2007
Richard Setzke Individual Corporate DirectorBoard Member Feb 21, 2024
Aistis J Tumas Individual Corporate DirectorBoard Member Feb 21, 2024
Tyler Wickman Individual Corporate DirectorBoard Member Feb 21, 2024
Taylor Pearson Individual Corporate DirectorBoard Member Feb 21, 2024
Matthew F Anich Individual Corporate DirectorBoard Member Jun 7, 2007
Peggy Vanhollen-Kman Individual Corporate DirectorBoard Member Jun 1, 2015
Robert Lee Houle Individual Corporate DirectorBoard Member Feb 21, 2024
John Smylie Individual Corporate DirectorBoard Member May 1, 2017
Thomas C Cunningham Individual Corporate DirectorBoard Member Jan 26, 2012
Luke Daniel Beirl Individual Corporate OfficerInterim Ceo Feb 7, 2024
W-2 Managing EmployeeInterim Ceo Feb 7, 2024
Kent J Dumonseau Individual Corporate OfficerVP, Cfo Aug 9, 2013
W-2 Managing Employee Aug 19, 2013
Karen Hansen Individual Corporate DirectorBoard Member Feb 21, 2024
Regional Enterprises Inc Organization, Ashland, WI Non-profit Operational/Managerial Control Jul 2, 2007

Owners & managing parties with NPI records 1

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

Facilities with the same owner 6

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

Practitioners & affiliated clinicians

Practitioners 193

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.

View all 193

Affiliated clinicians 207

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 207

NPI Registry JSON

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1700611200000",
    "number": "1437179231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1615 MAPLE LN",
            "city": "ASHLAND",
            "state": "WI",
            "postal_code": "548063610",
            "telephone_number": "715-685-5500",
            "fax_number": "715-685-5118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1615 MAPLE LN",
            "city": "ASHLAND",
            "state": "WI",
            "postal_code": "548063610",
            "telephone_number": "715-685-5500",
            "fax_number": "715-685-5118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEMORIAL MEDICAL CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-21",
        "last_updated": "2023-11-22",
        "certification_date": "2023-11-22",
        "status": "A",
        "authorized_official_last_name": "DOUGLAS",
        "authorized_official_first_name": "JASON",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "715-685-5512",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "273R00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Unit",
            "state": "WI",
            "license": "1066",
            "primary": false
        },
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "WI",
            "license": "1065",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00001048",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "301555922",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS BEH HEALTH INPT",
            "identifier": "0160JME",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "099847800",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID - CAH",
            "identifier": "11019510",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "405172492",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32947500",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROF COMPONENTS",
            "identifier": "36585ME",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "11019521",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "11019526",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32769900",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "11019500",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tamarack Health Ashland Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ashland, WI

Sources for this page

Verify at the official NPI Registry.