Organization Active NPI

Compassus Aah of Wisconsin II, LLC

Doing business as Compassus - Northern Wisconsin

  • Community Based Hospice Care Agency
  • Arbor Vitae, WI
National Provider Identifier
1740897925
Registry record updated Jun 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
COMPASSUS AAH OF WISCONSIN II, LLC
Doing business as
Compassus - Northern Wisconsin
Practice address
1571 US Highway 51 N Ste C
Arbor Vitae, WI 54568-9555
Phone
(715) 301-7200
NPI assigned
Sep 30, 2020
Last updated
Jun 28, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2021

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

Authorized official

Name
Russell Adkins
Title
SVP General Counsel
Phone
(615) 309-5668

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X NU Primary

Addresses

Primary practice location

1571 US Highway 51 N Ste C
Arbor Vitae, WI 54568-9555

Mailing address

10 Cadillac Dr Ste 400
Brentwood, TN 37027-1001
Phone (417) 841-4834

Other names 1

  • Compassus - Northern Wisconsin Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20201106000622 WI Part A Provider - Hospice 3678983483 Practice locations: Arbor Vitae, WI; Rhinelander, WI

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1740897925. Details of each certification follow.

Hospice certification: CCN 521509

Legal name
COMPASSUS AAH OF WISCONSIN II LLC
Doing business as
COMPASSUS - NORTHERN WISCONSIN
Certification status
Active
Provider type (POS)
Hospice
Participating since
Aug 7, 1986
Last certification
Apr 15, 2021
Ownership / control type
Proprietary - Corporation
Organization structure
LLCProprietary
Incorporated
Aug 3, 2020 in DE
Enrollment address
1571 Highway 51 N
Ste C
Arbor Vitae, WI 54568-9555

Care Compare: Hospice

Medicare Care Compare
Listed as
Compassus Northern WisconsinCCN 521509 · All quality measures
Ownership
For-Profit
Certified
Aug 7, 1986
Medicare certification status
ActiveFrom the Provider of Services file

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
52D0900060Compassus - Northern Wisconsin1571 Highway 51N, Suite C, Arbor Vitae, WI 54568Certificate of waiverJun 13, 2027

National Provider Directory

National Provider Directory

Locations

1571 US Highway 51 N
Ste C
Arbor Vitae, WI 54568
Phone (715) 301-7200

Ownership & related parties

All disclosed owners & managing parties 19

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

NameRoleSinceShare
Compassus Parent, Inc. Organization, New York, NY Corporation, For-profit 5% Or Greater Indirect Ownership Interest Oct 1, 2020 100%
FC Compassus LLC Organization, Brentwood, TN LLC, For-profit 5% Or Greater Indirect Ownership Interest Oct 1, 2020 100%
Washington State Investment Board Organization, Olympia, WA LLC, For-profit 5% Or Greater Indirect Ownership Interest Oct 1, 2020 5.28%
Russell G Adkins Individual Corporate OfficerSenior Vice President, General C Oct 1, 2020
Operational/Managerial ControlSenior Vice President, General C Oct 1, 2020
Towerbrook Investors V 892 LP Organization, New York, NY For-profit 5% Or Greater Indirect Ownership Interest Oct 1, 2020 14.23%
Compassus Aah Holdings LLC Organization, Brentwood, TN LLC, For-profit 5% Or Greater Indirect Ownership Interest Oct 1, 2020 100%
Ascension Towerbrook Healthcare Opportunities LP Organization, New York, NY For-profit 5% Or Greater Indirect Ownership Interest Oct 1, 2020 47.66%
Compassus Holdings LP Organization, New York, NY For-profit 5% Or Greater Indirect Ownership Interest Oct 1, 2020 100%
Laura a Templeton Individual Corporate OfficerEvp, Chief Operating Officer Apr 12, 2023
Operational/Managerial ControlEvp, Chief Operating Officer Apr 12, 2023
Jeremy R Bolling Individual Corporate OfficerDivision President Jan 3, 2022
Compassus Aah Holdings of Wisconsin LLC Organization, Brentwood, TN LLC, For-profit 5% Or Greater Direct Ownership Interest Oct 1, 2020 100%
Ti V Compassus Investment Aggregator, L.P. Organization, New York, NY For-profit 5% Or Greater Indirect Ownership Interest Oct 1, 2020 49.84%
Compassus Intermediate Inc Organization, New York, NY Corporation, For-profit 5% Or Greater Indirect Ownership Interest Oct 1, 2020 100%
Towerbrook Investors V (Onshore) LP Organization, New York, NY For-profit 5% Or Greater Indirect Ownership Interest Oct 1, 2020 29.96%
Oghomwen K Sule Individual Contracted Managing EmployeeMD; Jul 1, 2020
Ascension Capital LLC Organization, Clayton, MO LLC, For-profit 5% Or Greater Indirect Ownership Interest Oct 1, 2020 47.63%
Amy L Nowak Individual W-2 Managing EmployeeAd; Oct 12, 2023
Ascension Health Alliance Organization, Clayton, MO Non-profit 5% Or Greater Indirect Ownership Interest Oct 1, 2020 47.63%
Ti V ASC Compassus Investment Aggregator LP Organization, New York, NY For-profit 5% Or Greater Indirect Ownership Interest Oct 1, 2020 97.5%

Owners & managing parties with NPI records 1

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

Facilities with the same owner 166

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

View all 166

Change-of-ownership history 1

DateEventCounterparty
Oct 1, 2020 Change of OwnershipThis provider was the buyer Ascension at HomeCCN 521509, WI, NPI 1861435471

Change of ownership 1

Medicare changes of ownership in which this facility was the buyer or the seller.

Practitioners & affiliated clinicians

Affiliated clinicians 2

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

NPI Registry JSON

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

{
    "created_epoch": "1601424000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1624838400000",
    "number": "1740897925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 CADILLAC DR STE 400",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370271001",
            "telephone_number": "417-841-4834",
            "fax_number": "866-955-8538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1571 US HIGHWAY 51 N STE C",
            "city": "ARBOR VITAE",
            "state": "WI",
            "postal_code": "545689555",
            "telephone_number": "715-301-7200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMPASSUS AAH OF WISCONSIN II, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-30",
        "last_updated": "2021-06-28",
        "certification_date": "2021-06-28",
        "status": "A",
        "authorized_official_last_name": "ADKINS",
        "authorized_official_first_name": "RUSSELL",
        "authorized_official_title_or_position": "SVP GENERAL COUNSEL",
        "authorized_official_telephone_number": "615-309-5668"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Compassus - Northern Wisconsin",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Compassus - Northern Wisconsin",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Arbor Vitae, WI

Sources for this page

Verify at the official NPI Registry.