NPIMap

Organization Active NPI

Scenic Bluffs Health Center, Inc

  • Federally Qualified Health Center (FQHC)
  • La Crosse, WI
National Provider Identifier
1760029722
Registry record updated Oct 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
SCENIC BLUFFS HEALTH CENTER, INC
Practice address
212 11TH St S
La Crosse, WI 54601-4397
Phone
(608) 654-5100
Fax
(608) 651-5120
NPI assigned
Dec 9, 2019
Organization subpart
Yes
Parent organization
SCENIC BLUFFS HEALTH CENTER, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 2, 2025

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

Authorized official

Name
Kim Hawthorne
Title
Ceo
Phone
(608) 654-5100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

212 11TH St S
La Crosse, WI 54601-4397

Mailing address

PO Box 39
Cashton, WI 54619-0039

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250317000431 WI Part A Provider - Federally Qualified Health Center (FQHC) 8325098296 Practice locations: La Crosse, WI

Federally qualified health center certification: CCN 521050

Legal name
SCENIC BLUFFS HEALTH CENTER INC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Mar 10, 2025
Last certification
Mar 10, 2025
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Enrollment address
212 11TH St S
La Crosse, WI 54601-4397

Other NPIs with the same Medicare PAC ID 1

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

National Provider Directory

National Provider Directory
Part of
Scenic Bluffs Health Center

Locations

620 Industrial Dr
Sparta, WI 54656

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
Dustin William Hundt Individual Corporate OfficerBoard Member May 22, 2024
Sandra Canelo Arriola Individual Corporate OfficerBoard Member Jun 28, 2023
Andre Paquette Individual Corporate OfficerBoard Member Jan 25, 2023
Michael Stewart Windle Individual Corporate OfficerBoard Member Aug 10, 2022
Hetti Anna Brown Individual Corporate OfficerBoard Member Jul 1, 2019
Matthew Bersagel Braley Individual Corporate OfficerBoard Member Jul 22, 2020
Rebecca Lyn Gretebeck Individual Corporate OfficerBoard Member May 1, 2017
Melvin Schmitz Individual Corporate OfficerBoard Member May 16, 2024
Robert Sanders Individual Corporate OfficerBoard Member Jan 25, 2023
Judith L Zabel Individual Corporate OfficerBoard Member May 16, 2019
Scenic Bluffs Health Center Inc Organization, Cashton, WI Corporation, Non-profit Operational/Managerial Control Jan 4, 1994
Daria M Sztaba Individual Contracted Managing EmployeeAd;Cfo Oct 28, 2024
Corporate DirectorCfo Oct 28, 2024
W-2 Managing EmployeeAd;Cfo Oct 28, 2024
Sonya Lenzendorf Individual Corporate OfficerBoard Member May 25, 2022
Ivan Agustin Munguia Torres Individual Corporate OfficerBoard Member May 22, 2024

Owners & managing parties with NPI records 1

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

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Scenic Bluffs Community Health CenterCashton, WI, CCN 521808 Federally qualified health center Operational/Managerial Control Apr 1, 1994

Owned or controlled facilities with NPI records 3

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 1

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

Practitioners & affiliated clinicians

Practitioners 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1575849600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1759363200000",
    "number": "1760029722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 39",
            "city": "CASHTON",
            "state": "WI",
            "postal_code": "546190039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 11TH ST S",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "546014397",
            "telephone_number": "608-654-5100",
            "fax_number": "608-651-5120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SCENIC BLUFFS HEALTH CENTER, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SCENIC BLUFFS HEALTH CENTER, INC",
        "enumeration_date": "2019-12-09",
        "last_updated": "2025-10-02",
        "certification_date": "2025-10-02",
        "status": "A",
        "authorized_official_last_name": "HAWTHORNE",
        "authorized_official_first_name": "KIM",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "608-654-5100"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Crosse, WI

Sources for this page

Verify at the official NPI Registry.