NPIMap

Organization Active NPI

Sauk Prairie Healthcare Inc

  • Medicare Defined Swing Bed Hospital Unit
  • Prairie Du Sac, WI
National Provider Identifier
1437298684
Registry record updated Feb 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medicare Defined Swing Bed Hospital UnitTaxonomy code 275N00000X
Legal business name
SAUK PRAIRIE HEALTHCARE INC
Practice address
260 26TH St
Prairie Du Sac, WI 53578-1599
Phone
(608) 643-3311
NPI assigned
Feb 5, 2007
Last updated
Feb 22, 2018By the provider in NPPES
Organization subpart
Yes
Parent organization
SAUK PRAIRIE HEALTHCARE INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 22, 2018

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

Authorized official

Name
James Dregney
Title
Cfo
Phone
(608) 643-7212

Specialties & licenses 1

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

Addresses

Primary practice location

260 26TH St
Prairie Du Sac, WI 53578-1599

Mailing address

PO Box 70
Prairie Du Sac, WI 53578-0070
Phone (608) 643-3311

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071106000801 WI Part A Provider - Hospital 8224948054 Practice locations: Prairie Du Sac, WI

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1437298684. Details of each certification follow.

Hospital certification: CCN 52U095

Legal name
SAUK PRAIRIE HEALTHCARE INC
Organization structure
CorporationNon-profit
Incorporated
Sep 5, 1958 in WI
Enrollment address
260 26TH St
Prairie Du Sac, WI 53578-2203
Other Hospital Practice Location
Hospital subgroups
Swing-bed approved

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).

National Provider Directory

National Provider Directory
Tax ID family
Sauk Prairie Memorial H9 organizations share this tax ID, including this one
Part of
Sauk Prairie Memorial H

Other organizations with this tax ID 8

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

Ownership & related parties

All disclosed owners & managing parties 13

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

NameRoleSinceShare
James Dregney Individual Corporate OfficerVP of Finance Jun 30, 2017
W-2 Managing EmployeeVP of Finance Jun 30, 2017
Kari Apel Individual Corporate DirectorBoard Member Apr 1, 2021
Ryan Kraemer Individual Corporate DirectorBoard Member Apr 1, 2018
Jeffrey Wright Individual Corporate DirectorBoard Member Apr 1, 2020
Brian Gorman Individual Corporate DirectorBoard Member Apr 1, 2021
Allen Peckham Individual Corporate Director Jan 31, 1943
Andrea Wyttenbach Gavot Individual Corporate Director Apr 1, 2020
Sara Shackleton Individual Corporate DirectorBoard Member Apr 1, 2022
Timothy Homar Individual Corporate DirectorBoard Member Apr 1, 2020
Todd a Schad Individual Corporate OfficerMD Apr 1, 2013
Corporate DirectorMD Apr 1, 2013
William Dalrymple Individual Corporate Director Apr 1, 2022
Thomas Schwartz Individual Corporate Director May 1, 2007
Shawn Lerch Individual Corporate OfficerCeo Jun 26, 2017

Owners & managing parties with NPI records 1

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

NPI Registry JSON

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

{
    "created_epoch": "1170633600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1519257600000",
    "number": "1437298684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 70",
            "city": "PRAIRIE DU SAC",
            "state": "WI",
            "postal_code": "535780070",
            "telephone_number": "608-643-3311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "260 26TH ST",
            "city": "PRAIRIE DU SAC",
            "state": "WI",
            "postal_code": "535781599",
            "telephone_number": "608-643-3311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAUK PRAIRIE HEALTHCARE INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SAUK PRAIRIE HEALTHCARE INC",
        "enumeration_date": "2007-02-05",
        "last_updated": "2018-02-22",
        "status": "A",
        "authorized_official_last_name": "DREGNEY",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "608-643-7212"
    },
    "taxonomies": [
        {
            "code": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": "WI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Prairie Du Sac, WI

Sources for this page

Verify at the official NPI Registry.