NPIMap

Organization Active NPI

Aspirus Rhinelander & Tomahawk Hospitals & Clinics, Inc.

Doing business as Aspirus Crandon Clinic

  • Rural Health Clinic/Center
  • Crandon, WI
National Provider Identifier
1699068692
Registry record updated Jun 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
ASPIRUS RHINELANDER & TOMAHAWK HOSPITALS & CLINICS, INC.
Doing business as
Aspirus Crandon Clinic
Practice address
400 W Glen St
Crandon, WI 54520-1355
Phone
(715) 478-3318
NPI assigned
May 24, 2011
Last updated
Jun 10, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2024

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

Authorized official

Name
Jerry M Yang
Title
SVP & Chief Financial Officer
Phone
(715) 847-2526

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X NU
Rehabilitation Clinic/Center 261QR0400X NU
Rural Health Clinic/Center 261QR1300X NU Primary

Addresses

Primary practice location

400 W Glen St
Crandon, WI 54520-1355

Mailing address

29980 Network PL
Chicago, IL 60673-1299
Phone (715) 847-2304

Other names 1

  • Aspirus Crandon Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI4 enrollments

Enrollment records 4

Enrollment IDStateProvider typePAC IDDetails
O20031126000706 WI Part B Supplier - Clinic/Group Practice 9335059856 Receives reassigned benefits from 980 practitioners
16 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Stevens Point, WI; Plover, WI; Tomahawk, WI; Wausau, WI; Wisconsin Rapids, WI; Wittenberg, WI; Woodruff, WI; Rhinelander, WI…
O20070523000724 WI Part A Provider - Critical Access Hospital 9335059856 Receives reassigned benefits from 12 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Tomahawk, WI
O20071120000332 WI Part A Provider - Hospital 9335059856 15 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Plover, WI; Amherst, WI; Iola, WI; Stevens Point, WI; Crandon, WI; Tomahawk, WI; Eagle River, WI; Rhinelander, WI…
O20110726000283 WI Part A Provider - Rural Health Clinic 9335059856 Practice locations: Crandon, WI

NPI to CCN mapping 3

The Medicare certification numbers (CCNs) connected to NPI 1699068692. Details of each certification follow.

Hospital certification: CCN 521313

Legal name
ASPIRUS RHINELANDER & TOMAHAWK HOSPITALS & CLINICS, INC.
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
May 1, 2001
Last certification
May 14, 2025
Beds
18
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Incorporated
Jul 1, 1981 in WI
Enrollment address
401 W Mohawk Dr
Ste 100
Tomahawk, WI 54487-2273
Other Hospital Practice Location

Hospital certification: CCN 520019

Legal name
ASPIRUS RHINELANDER & TOMAHAWK HOSPITALS & CLINICS, INC.
Doing business as
ASPIRUS RHINELANDER HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Sep 30, 2017
Beds
99
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Incorporated
Oct 1, 1983 in WI
Enrollment address
2251 N Shore Dr
Rhinelander, WI 54501-6710
Hospital subgroups
General

Rural health clinic certification: CCN 528541

Legal name
ASPIRUS RHINELANDER & TOMAHAWK HOSPITALS & CLINICS, INC.
Doing business as
ASPIRUS CRANDON CLINIC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
May 31, 2012
Last certification
Sep 10, 2019
Ownership / control type
2B
Organization structure
CorporationNon-profit
Incorporated
Oct 1, 1993 in WI
Enrollment address
400 W Glen St
Crandon, WI 54520-1355
Related CCNs
520019

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

View all 16

Other NPIs with the same Medicare PAC ID 16

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

View all 16

Other NPIs on the same Medicare enrollment 17

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

View all 17

Care Compare: Hospital

Medicare Care Compare
Listed as
Aspirus Rhinelander HospitalCCN 520019 · All quality measures
Overall star rating
3 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

Care Compare: Hospital

Medicare Care Compare
Listed as
Aspirus Tomahawk HospitalCCN 521313 · All quality measures
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
Michael Holzhueter Individual Corporate DirectorAssistant Secretary Aug 1, 2021
Jerry M Yang Individual Corporate OfficerSVP and Chief Financial Officer Feb 26, 2023
Corporate DirectorSVP and Chief Financial Officer Feb 26, 2024
W-2 Managing EmployeeSVP and Chief Financial Offic Feb 26, 2024
Operational/Managerial ControlSVP and Chief Financial Officer Feb 26, 2024
W-2 Managing EmployeeSVP and Chief Financial Officer Feb 26, 2024
Dean M Pollnow Individual Corporate DirectorBoard Member Oct 1, 2023
Holly L Beede-McKinney Individual Corporate DirectorBoard Member Aug 1, 2021
Aspirus, Inc Organization, Wausau, WI Non-profit 5% Or Greater Direct Ownership Interest Aug 1, 2021 100%
Kelly L Court Individual Corporate DirectorBoard Member Jul 1, 2019
Teresa J Theiler Individual W-2 Managing EmployeeManaging Employee Jan 1, 2021
Operational/Managerial ControlManaging Employee Jan 1, 2021
Amy Vanney Individual Corporate DirectorBoard Member Oct 1, 2023
Eric J Anderson Individual Corporate DirectorBoard Member Aug 1, 2021
Ronald Patterson Individual Corporate DirectorBoard Member Oct 1, 2023
Judith a Crouch-Smolarek Individual Corporate DirectorBoard Member/Chair Aug 1, 2021
Ryan Huseby Individual Corporate DirectorBoard Member Oct 1, 2023
Lori Peck Individual Corporate OfficerVP-Finance Aug 1, 2021
W-2 Managing EmployeeVP-Finance Aug 1, 2021
Operational/Managerial ControlVP-Finance Aug 1, 2021
Corporate DirectorVP - Finance Aug 1, 2021
Operational/Managerial ControlVP-Finance Aug 21, 2021
Kathleen C Ferrel Individual Corporate DirectorBoard Member Jul 1, 2018
Tyler Hack Individual Corporate DirectorVP - Revenue Cycle Feb 26, 2024
W-2 Managing EmployeeVP - Revenue Cycle Feb 26, 2024
Operational/Managerial ControlVP - Revenue Cycle Feb 26, 2024
W-2 Managing EmployeeVP-Finance Feb 26, 2024
Operational/Managerial ControlSVP and Chief Financial Officer Feb 26, 2024
Matthew F Heywood Individual Corporate DirectorCeo Aug 1, 2021
W-2 Managing EmployeeCeo Aug 1, 2021
Operational/Managerial ControlCeo Aug 1, 2021
Arthur C Helgerson Individual Corporate DirectorBoard Member Jun 1, 2014

Owners & managing parties with NPI records 3

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

Facilities with the same owner 79

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

View all 79

Practitioners & affiliated clinicians

Practitioners 30

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 30

Affiliated clinicians 548

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

View all 548

NPI Registry JSON

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

{
    "created_epoch": "1306195200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717977600000",
    "number": "1699068692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29980 NETWORK PL",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606731299",
            "telephone_number": "715-847-2304",
            "fax_number": "715-843-1188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 W GLEN ST",
            "city": "CRANDON",
            "state": "WI",
            "postal_code": "545201355",
            "telephone_number": "715-478-3318"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASPIRUS RHINELANDER & TOMAHAWK HOSPITALS & CLINICS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-24",
        "last_updated": "2024-06-10",
        "certification_date": "2024-06-10",
        "status": "A",
        "authorized_official_last_name": "YANG",
        "authorized_official_first_name": "JERRY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "SVP & CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "715-847-2526"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Aspirus Crandon Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Crandon, WI

Sources for this page

Verify at the official NPI Registry.