Upper Mississippi Surgery Center, LLC

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

Legal business name

UPPER MISSISSIPPI SURGERY CENTER, LLC

Practice address

454 Badger Rd
Hazel Green, WI 53811-9787

Phone

(608) 608-2576

Fax

(605) 274-6186

NPI assigned

Jul 6, 2026

Organization subpart

Yes

Parent organization

UPPER MISSISSIPPI SURGERY CENTER, LLCAs reported in NPPES

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

Authorized official

Name

Susan Marie Gourley

Title

Administrator

Phone

(608) 473-1700

Specialties & licenses 1

Addresses

Tax ID family

Upper Mississippi Surgery Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Upper Mississippi Surgery Center, LLC

  • Ambulatory Surgical Clinic/Center
  • Hazel Green, WI
  • NPI 1952153991
  NPD tax ID

Locations

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Upper Mississippi Surgery Center, LLC

  • Ambulatory Surgical Clinic/Center
  • Hazel Green, WI
  • NPI 1952153991
  NPPES parent name

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

{
    "created_epoch": "1783296000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1783296000000",
    "number": "1477470847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "454 BADGER RD",
            "city": "HAZEL GREEN",
            "state": "WI",
            "postal_code": "538119787",
            "telephone_number": "608-608-2576",
            "fax_number": "605-274-6186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "454 BADGER RD",
            "city": "HAZEL GREEN",
            "state": "WI",
            "postal_code": "538119787",
            "telephone_number": "608-608-2576",
            "fax_number": "605-274-6186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UPPER MISSISSIPPI SURGERY CENTER, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "UPPER MISSISSIPPI SURGERY CENTER, LLC",
        "enumeration_date": "2026-07-06",
        "last_updated": "2026-07-06",
        "certification_date": "2026-07-06",
        "status": "A",
        "authorized_official_last_name": "GOURLEY",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "608-473-1700"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ann Marie Miesen, BSN, RN
• Courtney Runde, LISW
• Sinsinawa Nursing Inc (Saint Dominic Villa)
• Southwestern School District
• Dana Rae Stangl, RN
• Upper Mississippi Surgery Center, LLC
• Lauren Vos, DPT

• Certified Registered Nurse Anesthetist in Hazel Green, WI
• Providers in Hazel Green, WI by specialty
• Certified Registered Nurse Anesthetist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2026; 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.