Amery Regional Medical Center, Inc.
Organization Active NPI Psychiatric Hospital Unit · Amery, WI
NPI 1699003202 · NPPES record last updated Sep 11, 2026
Key facts
- NPI
- 1699003202
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Psychiatric Hospital Unit 273R00000X
- License
- 1069 (WI)
- Legal business name
- AMERY REGIONAL MEDICAL CENTER, INC.
- Practice address
- 230 Deronda St
Amery, WI 54001-1412 - Phone
- (715) 268-8000
- Fax
- (715) 268-0071
- NPI assigned
- Nov 20, 2009
- Organization subpart
- No
Authorized official
- Name
- Steven Massey
- Title
- President
- Phone
- (715) 243-2850
Owners & managing parties with NPI records 14
-
Steven Long, DO
-
Annie M Jacobsen, M.D.
Other NPIs on the same Medicare enrollment 1
Other NPIs with the same Medicare PAC ID 6
Corporate family (same tax ID) 5
Related certifications (CCN) 4
Facilities with the same owner 8
Practitioners 126
-
Anne C Dibala, MD
-
Michael A Albano, D.O.
-
Brittany Beeson, M.D.
-
Kris Budke, CRNA
-
Erica L Burger, D.O.
-
Dylan Coe, MD
-
Daniel S Crawley IV, M.D.
-
Courtney Dahl, DO
-
Mary Agnes Dahl, MD
-
Ronda D Davis, MD
-
David O. Degear, M.D.
-
Alexa Evon Demoe, LPC
-
David Deuth, DO
-
Lorant Divald, M.D.
-
Kyra Mackenzie Engquist, PA-C
-
Nicole Beverly Feser, DNP, CNP
-
Taylor Feuling, MD
-
Nathan C Fritsch, CRNA
-
Amanda Margaret Gibbs, PA-C
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 52D2008895 | Amery Regional Medical Center- West Campus | Certificate of waiver | Jun 20, 2028 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
Hospital certification: CCN 52M308
- Legal name
- AMERY REGIONAL MEDICAL CENTER INC
- Doing business as
- AMERY HOSPITAL & CLINIC - BEHAVIORAL HEALTH CENTER
- Organization structure
- Corporation · Non-profit
- Incorporated
- Jul 1, 1998 in WI
- Enrollment address
- 230 Deronda St
Amery, WI 54001-1412
All disclosed owners & managing parties 24
| Name | Role | Since | Share |
|---|---|---|---|
| Steven Massey |
Corporate Director |
Apr 27, 2026 | |
| Jason Gallagher |
Corporate Director | Jan 1, 2024 | |
| Jack R Dressen |
Corporate Director | Jan 1, 2026 | |
| Khu Thao |
Corporate Director | Aug 1, 2023 | |
| Group Health Plan Inc |
Operational/Managerial Control | Jan 1, 2014 | |
| Nicholas Weiss |
Corporate Director | Jan 1, 2026 | |
| Melissa Kolb |
Corporate Director | Apr 1, 2020 | |
| Michael Anderson |
Corporate Director | Jan 1, 2019 | |
| Sharon Tolva |
Corporate Director | Jan 1, 2019 | |
| Annie Jacobsen |
Corporate Director | Aug 1, 2023 | |
| Mark Gherty |
Corporate Director | May 1, 2018 | |
| Richard G Dado |
Corporate Director | Jun 10, 2019 | |
| Criag Yehlik |
Corporate Director | Jan 1, 2020 | |
| Kris Tjornehoj |
Corporate Director | May 1, 2018 | |
| Levon O Haodha |
Corporate Director | Apr 1, 2018 | |
| Regan Brown |
Corporate Director | Jan 1, 2019 | |
| Alita R Risinger |
Corporate Officer |
Jul 1, 2024 | |
| Oralee Schock |
Corporate Director | May 1, 2017 | |
| Pahoua Hoffman |
Corporate Director | May 1, 2023 | |
| Lisa Bjorkman |
W-2 Managing Employee |
Jul 27, 2015 | |
| Bremer Bank National Association |
5% Or Greater Security Interest | May 27, 2021 | 24% |
| Paula Kolbeck |
Corporate Director | Jan 1, 2020 | |
| Charles Williamson |
Corporate Director | Mar 1, 2020 | |
| Steven Long |
Corporate Director | Oct 26, 2022 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20080929000736 | WI | Part a Provider - Critical Access Hospital | 2769391960 |
Receives reassigned benefits from 2 practitioners 1 other NPI on this enrollment Practice locations: Amery, WI |
National Provider Directory
- Tax ID family
- Amery Regional Med CT
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Clinic/Center (Including Community Mental Health Center) | 261QM0801X | 528516 RHC | WI | |
| Psychiatric Hospital Unit | 273R00000X | 1069 | WI | Yes |
Addresses
Primary practice location
230 Deronda St
Amery, WI 54001-1412
Mailing address
8170 33Rd Ave S
Mailstop 21110Q
Bloomington, MN 55425-4516
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 528516 | Other | WI | RURAL HEALTH CLINIC LUCK CLINIC |
Other names
- Amery Hospital & Clinic - Behavioral Health Center
Other providers in Amery, WI
- Amery Regional Medical Center
- Amery Regional Medical Center, Inc
- Amery Regional Medical Center, Inc.
- Amery Regional Medical Center, Inc.
- Amery Regional Medical Center, Inc.
- Nathan Patrick Anderson
- Tiffany Anderson
- Murad Aslam
- Aspen Guardian Services, Inc.
- Lynnette A Barrineau
All providers in Amery, WI · Psychiatric 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 Sep 11, 2026. 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.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.