NPIMap

Organization Active NPI

Richland Hospital

  • Critical Access Hospital
  • Richland Center, WI
National Provider Identifier
1659301273
Registry record updated Jan 15, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
Legal business name
RICHLAND HOSPITAL
Practice address
333 E 2ND St
Richland Center, WI 53581-1914
Phone
(608) 647-6321
Fax
(608) 647-6898
NPI assigned
Jul 3, 2006
Last updated
Jan 15, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2009

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

Authorized official

Name
Lana Myers
Title
Manager Patient Accounting
Phone
(608) 647-6321

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Access Hospital 282NC0060X Primary

Addresses

Primary practice location

333 E 2ND St
Richland Center, WI 53581-1914

Mailing address

333 E 2ND St
Richland Center, WI 53581-1914
Phone (608) 647-6321

Other identifiers 2

IdentifierTypeStateIssuer
11015500MedicaidWI
11015510MedicaidWI

Medicare participation

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

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20040417000343 WI Part B Supplier - Clinic/Group Practice 7618861618 Receives reassigned benefits from 9 practitioners
Practice locations: Richland Center, WI
O20090210000218 WI Part A Provider - Critical Access Hospital 7618861618 Receives reassigned benefits from 114 practitioners
Practice locations: Richland Center, WI
O20110318000356 WI Part B Supplier - Clinic/Group Practice 7618861618 Receives reassigned benefits from 175 practitioners
1 other NPI on this enrollment
Practice locations: Richland Center, WI; Spring Green, WI

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1659301273. Details of each certification follow.

Hospital certification: CCN 521341

Legal name
RICHLAND HOSPITAL
Doing business as
RICHLAND HOSPITAL INC
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Jul 8, 2004
Last certification
Jul 9, 2004
Beds
25
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Incorporated
Nov 1, 1927 in WI
Enrollment address
333 E 2ND St
Richland Center, WI 53581-1914

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

Other NPIs with the same Medicare PAC ID 5

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

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Hospital

Medicare Care Compare
Listed as
Richland HospitalCCN 521341 · All quality measures
Overall star rating
1 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 6

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

NameRoleSinceShare
Bruce Roesler Individual Corporate Director Mar 9, 2015
W-2 Managing EmployeeCeo Mar 9, 2015
John Annear Individual Corporate Director Apr 25, 2016
John Poole Individual Corporate Director Apr 25, 2015
Jeffrey C Longbrake Individual Contracted Managing Employee Jan 29, 2019
Corporate DirectorCfo Jan 29, 2019
Traci Lynn Peterson Individual Corporate Director Apr 25, 2016
Marilyn Rinehart Individual Corporate Director Apr 25, 2016

Owners & managing parties with NPI records 1

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

Practitioners & affiliated clinicians

Practitioners 207

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 207

Affiliated clinicians 163

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

View all 163

NPI Registry JSON

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

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1231977600000",
    "number": "1659301273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 E 2ND ST",
            "city": "RICHLAND CENTER",
            "state": "WI",
            "postal_code": "535811914",
            "telephone_number": "608-647-6321",
            "fax_number": "608-647-6898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 E 2ND ST",
            "city": "RICHLAND CENTER",
            "state": "WI",
            "postal_code": "535811914",
            "telephone_number": "608-647-6321",
            "fax_number": "608-647-6898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RICHLAND HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-03",
        "last_updated": "2009-01-15",
        "status": "A",
        "authorized_official_last_name": "MYERS",
        "authorized_official_first_name": "LANA",
        "authorized_official_title_or_position": "MANAGER PATIENT ACCOUNTING",
        "authorized_official_telephone_number": "608-647-6321"
    },
    "taxonomies": [
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "11015500",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "11015510",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Richland Center, WI

Sources for this page

Verify at the official NPI Registry.