NPIMap

Organization Active NPI

Mayo Clinic Health System-Northwest Wisconsin Region, Inc.

  • Critical Access Hospital
  • Bloomer, WI
National Provider Identifier
1700837812
Registry record updated Aug 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
Legal business name
MAYO CLINIC HEALTH SYSTEM-NORTHWEST WISCONSIN REGION, INC.
Practice address
1501 Thompson St
Bloomer, WI 54724-1257
Phone
(715) 838-5270
NPI assigned
May 13, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2026

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

Authorized official

Name
Adam Smith
Title
Cfo
Phone
(715) 838-5275

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Access Hospital 282NC0060X Primary
Clinical Medical Laboratory 291U00000X

Addresses

Primary practice location

1501 Thompson St
Bloomer, WI 54724-1257

Mailing address

1501 Thompson St
Bloomer, WI 54724-1257

Other identifiers 1

IdentifierTypeStateIssuer
11018500MedicaidWI

Other names 2

  • Mayo Clinic Health System-Bloomer Doing business as
  • Mayo Clinic Health System-Chippewa Valley Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Ability Network

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20171012001230 WI Part A Provider - Critical Access Hospital 4385553627 Receives reassigned benefits from 456 practitioners
Practice locations: Bloomer, WI; Chippewa Falls, WI

Hospital certification: CCN 521314

Legal name
MAYO CLINIC HEALTH SYSTEM-NORTHWEST WISCONSIN REGION INC
Doing business as
MAYO CLINIC HEALTH SYSTEM-CHIPPEWA VALLEY
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Jul 1, 2001
Last certification
Jul 2, 2014
Beds
15
Ownership / control type
Private (not for profit)
Most recent change of ownership
Jan 1, 2018 (2 total)
Organization structure
CorporationNon-profit
Incorporated
May 11, 1905 in WI
Enrollment address
1501 Thompson St
Bloomer, WI 54724-1257

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

Other NPIs with the same Medicare PAC ID 20

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

View all 20

Care Compare: Hospital

Medicare Care Compare
Listed as
Mayo Clinic Health System Chippewa ValleyCCN 521314
Overall star rating
4 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
Tax ID family
Mayo Clinic Health System-Northwest Wisconsin Region Inc25 organizations share this tax ID, including this one

Other organizations with this tax ID 24

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

View all 24

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

Locations

220 Douglas St
Chetek, WI 54728
Phone (715) 924-4811

1010 High St
Colfax, WI 54730
Phone (715) 926-3117

1061 Menomonie St
Eau Claire, WI 54703

2424 Alpine Rd
Eau Claire, WI 54703
Phone (715) 832-9739

3845 London Rd
Eau Claire, WI 54701
Phone (715) 838-3872

302 10th Ave E
Menomonie, WI 54751
Phone (715) 232-5132

Ownership & related parties

All disclosed owners & managing parties 16

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

NameRoleSinceShare
Matthew J Olmstead Individual Corporate DirectorBoard Member Jan 1, 2025
Paul Molling Individual Corporate OfficerVice Chair Mar 11, 2026
Corporate DirectorBoard Member Mar 11, 2026
Franklin K Ackerman Individual Corporate OfficerSecretary Jan 1, 2025
Corporate DirectorBoard Member Jan 1, 2025
Jason Beckermann Individual Corporate DirectorBoard Member Jan 1, 2025
Dean B Eide Individual W-2 Managing EmployeeVice Chair Administration Oct 1, 2021
Timothy J Young Individual Corporate DirectorBoard Member Jan 1, 2025
Richard a Helmers Individual Corporate OfficerCeo & Chair Jan 1, 2018
Corporate DirectorBoard Member Jan 1, 2018
Lisa Gillette Individual Corporate DirectorBoard Member May 1, 2026
Charles W Nordstrom Individual Corporate DirectorBoard Member Jan 1, 2025
Kevin M Fitzgerald Individual Corporate DirectorBoard Member Jan 1, 2025
Gurpreet Singh Individual Corporate DirectorBoard Member Jan 1, 2025
Robert J Wiechmann Individual Corporate DirectorBoard Member Jan 1, 2025
Mayo Clinic Organization, Rochester, MN Corporation, Non-profit Operational/Managerial Control Jan 1, 2018
Adam W Smith Individual Corporate OfficerCfo & Treasurer Jan 19, 2026
Corporate DirectorBoard Member Jan 19, 2026
Kelly M Buchholtz Individual Corporate DirectorBoard Member Jan 1, 2025
Janel N Glantz Individual Corporate DirectorBoard Member Jan 1, 2025

Owners & managing parties with NPI records 16

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

View all 16

Facilities with the same owner 38

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

View all 38

Practitioners & affiliated clinicians

Practitioners 1,050

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 1,050

Affiliated clinicians 370

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

View all 370

NPI Registry JSON

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

{
    "created_epoch": "1147478400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1786924800000",
    "number": "1700837812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 THOMPSON ST",
            "city": "BLOOMER",
            "state": "WI",
            "postal_code": "547241257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 THOMPSON ST",
            "city": "BLOOMER",
            "state": "WI",
            "postal_code": "547241257",
            "telephone_number": "715-838-5270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAYO CLINIC HEALTH SYSTEM-NORTHWEST WISCONSIN REGION, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-13",
        "last_updated": "2026-08-17",
        "certification_date": "2026-08-17",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "ADAM",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "715-838-5275"
    },
    "taxonomies": [
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "11018500",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "Ability Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "64 S Price Rd SteB",
            "city": "Brownsville",
            "state": "TX",
            "country_code": "US",
            "postal_code": "785212459",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Mayo Clinic Health System-Bloomer",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Mayo Clinic Health System-Chippewa Valley",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bloomer, WI

Sources for this page

Verify at the official NPI Registry.