NPIMap

Moundview Memorial Hospital & Clinics, Inc.

Organization Active NPI Medicare Defined Swing Bed Hospital Unit · Friendship, WI

NPI 1720147366 · NPPES record last updated Jul 13, 2026

Key facts

NPI
1720147366
Entity type
Organization (NPI type 2)
Primary specialty
Medicare Defined Swing Bed Hospital Unit 275N00000X
Legal business name
MOUNDVIEW MEMORIAL HOSPITAL & CLINICS, INC.
Practice address
402 W Lake St
Friendship, WI 53934-9699
Phone
(608) 339-3331
NPI assigned
Dec 8, 2006
Organization subpart
Yes
Parent organization (as reported)
MOUNDVIEW MEMORIAL HOSPITAL & CLINICS, INC.

Authorized official

Name
Mrs. Lori Wittig
Title
Administrator
Phone
(608) 339-8318

Owners & managing parties with NPI records 1

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

Other NPIs on the same Medicare enrollment 3

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

Other NPIs with the same Medicare PAC ID 4

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

Corporate family (same tax ID) 4

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

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

Facilities with the same owner 49

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

View all 49

Practitioners 100

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

View all 100

Affiliated clinicians 1

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

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in WI

Hospital certification: CCN 52Z309

Legal name
MOUNDVIEW MEMORIAL HOSPITAL & CLINICS, INC.
Doing business as
GUNDERSEN MOUNDVIEW HOSPITAL AND CLINICS
Organization structure
Corporation · Non-profit
Incorporated
Jul 29, 1954 in WI
Enrollment address
402 W Lake St
Friendship, WI 53934-9699
Other Hospital Practice Location

All disclosed owners & managing parties 13

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

NameRoleSinceShare
Stephanie L Carroll
Individual 		Corporate Director Jul 13, 2020
Joseph Thiesen
Individual 		Corporate Director Jul 13, 2020
Lori Wittig
Individual 		Corporate Director
Ceo / Administrator		 Jan 31, 2026
Tadd Wormet
Individual 		Corporate Director Feb 1, 2022
Michael Eckstein
Individual 		Corporate Director
Board Member		 Jan 1, 2026
Eric Dehn
Individual 		Corporate Director
Board Member		 Jan 1, 2026
Jennifer Parr
Individual 		Corporate Director
Board Member		 Jan 1, 2025
Bellin Gundersen Health System Inc
Organization · La Crosse, WI
Corporation, Non-profit 		5% Or Greater Indirect Ownership Interest Nov 30, 2022
Operational/Managerial Control Nov 30, 2022
Laurie Inda
Individual 		Corporate Director Jan 1, 2023
Paul R Fisch
Individual 		Corporate Director Jan 1, 2019
Roxanne Potts
Individual 		Corporate Director May 1, 2019
Kurtis K Miller
Individual 		W-2 Managing Employee
Local Integrity Officer		 Mar 5, 2013
Gundersen Lutheran Health System Inc
Organization · La Crosse, WI
Corporation, Non-profit 		Operational/Managerial Control Oct 1, 2017

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20031121000846 WI Part B Supplier - Clinic/Group Practice 1355250432 Receives reassigned benefits from 300 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Friendship, WI; Westfield, WI
O20040422000095 WI Part a Provider - Critical Access Hospital 1355250432 Practice locations: Friendship, WI

National Provider Directory

Tax ID family
Moundview Memorial Hospital (5 organizations share this tax ID)
Part of
Moundview Memorial Hospital

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Medicare Defined Swing Bed Hospital Unit 275N00000X Yes

Addresses

Primary practice location

402 W Lake St
Friendship, WI 53934-9699

Mailing address

PO Box 40
Friendship, WI 53934-0040
Phone (608) 339-3331

Other identifiers

IdentifierTypeStateIssuer
11012000MedicaidWI
CR0660OtherWIMEDICARE RAILROAD

Other names

  • Gundersen Moundview Hospital and Clinics, Inc. Doing business as

Other providers in Friendship, WI

All providers in Friendship, WI · Medicare Defined Swing Bed Hospital Unit in Wisconsin

Sources for this page

Verify at the official NPI Registry.