NPIMap

Organization Active NPI

St. Joseph's Health Services, Inc.

  • Clinic/Center
  • Elroy, WI
National Provider Identifier
1699788273
Registry record updated Jun 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
ST. JOSEPH'S HEALTH SERVICES, INC.
Practice address
1705 Omaha St
Elroy, WI 53929-9776
Phone
(608) 489-8270
Fax
(608) 489-8188
NPI assigned
Aug 14, 2006
Last updated
Jun 4, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2012

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

Authorized official

Name
Pamela K Dewitt
Title
Cfo
Phone
(608) 489-8103

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X NU Primary

Addresses

Primary practice location

1705 Omaha St
Elroy, WI 53929-9776

Mailing address

PO Box 527
Hillsboro, WI 54634-0527
Phone (608) 489-8270

Other identifiers 4

IdentifierTypeStateIssuer
78B97JOOtherMNBCBS MINNESOTA
P10OtherWIDEAN HEALTH PLAN
78B97JOOtherWIATRIUM
32762900MedicaidWI

Other names 1

  • St. Joseph's Health Services - Elroy Clinic Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040615000273 WI Part B Supplier - Clinic/Group Practice 3971586439 Receives reassigned benefits from 307 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Wonewoc, WI; Whitehall, WI; Viroqua, WI; Prairie Du Chien, WI; Onalaska, WI; Mequon, WI; Madison, WI; La Crosse, WI…
O20140724001029 WI Part A Provider - Rural Health Clinic 3971586439 Practice locations: Elroy, WI

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1699788273. Details of each certification follow.

Rural health clinic certification: CCN 528568

Legal name
ST JOSEPH'S HEALTH SERVICES INC
Doing business as
GUNDERSEN ST JOSEPHS HOSPITAL & CLINICS
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
May 4, 2015
Last certification
May 4, 2015
Ownership / control type
2B
Organization structure
CorporationNon-profit
Incorporated
Jun 6, 1949 in WI
Enrollment address
125 Main St
Elroy, WI 53929-1249
Related CCNs
521304

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

Other NPIs with the same Medicare PAC ID 4

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

Other NPIs on the same Medicare enrollment 4

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

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
52D2123025St Joseph's Health Services, Inc - Elroy1705 Omaha, Elroy, WI 53929Certificate of waiverJul 31, 2027

National Provider Directory

National Provider Directory
Tax ID family
St Joseph's Community Health Services Inc6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

Locations

125 Main St
Elroy, WI 53929
Phone (608) 462-4116

1705 Omaha St
Elroy, WI 53929
Phone (608) 462-8270

301 Railroad Rd
Wonewoc, WI 53968
Phone (608) 464-3111

Ownership & related parties

All disclosed owners & managing parties 14

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

NameRoleSinceShare
Natalie Adams Individual Corporate DirectorBoard Member Jan 1, 2021
Jennifer Boigenzahn Individual Corporate OfficerFinance Administrator Mar 31, 2025
W-2 Managing EmployeeFinance Admin Feb 1, 2026
Dana Meyers Individual Corporate DirectorBoard Member Oct 1, 2020
Ann M Brandau-Hynek Individual Corporate OfficerSecretary Mar 1, 2014
Bellin Gundersen Health System Inc Organization, La Crosse, WI Corporation, Non-profit 5% Or Greater Indirect Ownership Interest Nov 30, 2022 100%
Operational/Managerial Control Nov 30, 2022
Kraig Schuster Individual Corporate OfficerVP - Operations Feb 1, 2026
Jon Woolever Individual Corporate DirectorBoard Member Jan 1, 2025
Michael McKee Individual Corporate Director Jun 21, 2018
Jeri Weger Individual Corporate DirectorCommunity Board Member Apr 17, 2025
Gundersen Lutheran Health System Inc Organization, La Crosse, WI Corporation, Non-profit 5% Or Greater Direct Ownership Interest Mar 1, 2014 100%
Operational/Managerial Control Mar 1, 2014
Annette Lechnir Individual Corporate Director Jan 1, 2023
Hannah Young Individual Corporate OfficerAdministrator Jun 1, 2026
Stacie Christensen Individual Corporate Director Feb 1, 2022
Holly Boisen Individual Corporate Director Jan 1, 2023

Facilities with the same owner 49

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

View all 49

Practitioners & affiliated clinicians

Practitioners 324

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 324

NPI Registry JSON

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

{
    "created_epoch": "1155513600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1338768000000",
    "number": "1699788273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 527",
            "city": "HILLSBORO",
            "state": "WI",
            "postal_code": "546340527",
            "telephone_number": "608-489-8270",
            "fax_number": "608-489-8188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1705 OMAHA ST",
            "city": "ELROY",
            "state": "WI",
            "postal_code": "539299776",
            "telephone_number": "608-489-8270",
            "fax_number": "608-489-8188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. JOSEPH'S HEALTH SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-14",
        "last_updated": "2012-06-04",
        "status": "A",
        "authorized_official_last_name": "DEWITT",
        "authorized_official_first_name": "PAMELA",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "608-489-8103"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS MINNESOTA",
            "identifier": "78B97JO",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEAN HEALTH PLAN",
            "identifier": "P10",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ATRIUM",
            "identifier": "78B97JO",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32762900",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St. Joseph's Health Services - Elroy Clinic",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Elroy, WI

Sources for this page

Verify at the official NPI Registry.