Aspirus Medford Hospital & Clinics, Inc.
Organization Active NPI Rural Health Clinic/Center · Athens, WI
NPI 1760912919 · NPPES record last updated Feb 26, 2026
Key facts
- NPI
- 1760912919
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Rural Health Clinic/Center 261QR1300X
- Legal business name
- ASPIRUS MEDFORD HOSPITAL & CLINICS, INC.
- Practice address
- 729 Pine St
Athens, WI 54411-9305 - Phone
- (715) 748-8100
- NPI assigned
- Jun 19, 2017
- Organization subpart
- No
Authorized official
- Name
- Lori Peck
- Title
- SVP- Chief Financial Officer
- Phone
- (715) 847-2575
Owners & managing parties with NPI records 3
-
Diane M Anderson, FNPC
-
Rachel Dixon, PA-C
Other NPIs on the same Medicare enrollment 8
Other NPIs with the same Medicare PAC ID 8
Corporate family (same tax ID) 10
Related certifications (CCN) 9
Facilities with the same owner 79
Practitioners 138
-
Diane M Anderson, FNPC
-
Ngozi J Ekwueme, MD
-
Taylor Jean Ewert, FNP-C
-
Marjorie S. Miller, M.D.
-
Nicole Marie Paul, FNP
-
Sammy U Rehman, DO
-
Mary Beth Reynolds, FNP-BC, APNP
-
Clint G Semrau, DO
-
Gregory Lee Werner, P.A.-C
-
Justin C Wright, PA-C
-
Omar Mahmoud El-Sheikh, MD, MSC, FRCS
-
Amir Fallahian, MD
-
Scherly Leon, M.D.
-
Daniel Portal, MD
-
Katharine Van Fossen, M.D.
-
Bryan Kincaid Austin, MD, MS
-
Cynthia Joy Bainbridge, PH.D.
-
John Berlin, FNP
-
Philip Michael Bovet, DO, MPH
-
Ronald J Cooper, MD
-
Tracy L Cousins, M.D.
Affiliated clinicians 193
-
Sandeep Aggarwal, MD
-
Jeffrey Terrence Ambord, PA-C
-
Diane M Anderson, FNPC
-
Katy Lynn Anderson, APNP
-
Austin Belton, MD
-
John Berlin, FNP
-
John C Berschback, M.D.
-
Vera Bocoun, MD
-
Philip Michael Bovet, DO, MPH
-
Kelsey J Brost, PA-C
-
Michael John Connolly, M.D.
-
Ronald J Cooper, MD
-
Tracy L Cousins, M.D.
-
James M Cygan, MD
-
Amy Jeanne Defranco, ARNP
-
Rachel Dixon, PA-C
-
Matthew J Dombrowski, PA-C
-
Cassandra Donathan, PA-C
-
James Everett Dunn, M.D.
-
David K Durnick, M.D.
Medicare Care Compare: Hospital
- Listed as
- Aspirus Medford Hospital & Clinics, Inc
- Type
- Critical Access Hospitals
- Ownership
- Voluntary non-profit - Private
- Medicare certification status
- Active
- Emergency services
- Yes
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 52D2133745 | Aspirus Athens Clinic | Certificate of waiver | Sep 30, 2026 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (3 enrollments) in WI
Hospital certification: CCN 521324
- Legal name
- ASPIRUS MEDFORD HOSPITAL & CLINICS INC
- Certification status
- Active
- Provider type (POS)
- Hospital – Critical access hospital
- Participating since
- Jun 10, 2002
- Last certification
- Jul 15, 2015
- Beds
- 15
- Ownership / control type
- Private (not for profit)
- Organization structure
- Corporation · Non-profit
- Incorporated
- Jun 2, 1958 in WI
- Enrollment address
- 135 S Gibson St
Medford, WI 54451-1622
Rural health clinic certification: CCN 528583
- Legal name
- ASPIRUS MEDFORD HOSPITAL & CLINICS INC
- Doing business as
- ASPIRUS ATHENS CLINIC
- Certification status
- Active
- Provider type (POS)
- Rural health clinic
- Participating since
- Nov 27, 2017
- Last certification
- Nov 27, 2017
- Ownership / control type
- 2B
- Organization structure
- Corporation · Non-profit
- Incorporated
- Jun 2, 1958 in WI
- Enrollment address
- 729 Pine St
Athens, WI 54411-9305 - Related CCNs
- 521324
All disclosed owners & managing parties 17
| Name | Role | Since | Share |
|---|---|---|---|
| Jeffrey Koenig |
Corporate Director |
Nov 1, 2023 | |
| Michael Holzhueter |
Corporate Director |
Oct 1, 2019 | |
| Jerry M Yang |
Corporate Director |
Feb 26, 2024 | |
| W-2 Managing Employee |
Feb 26, 2024 | ||
| Operational/Managerial Control |
Feb 26, 2024 | ||
| Randy Juedes |
Corporate Director |
Oct 1, 2019 | |
| John Lange |
Corporate Director |
Oct 1, 2020 | |
| Susan M Schneider |
Corporate Director |
Oct 1, 2020 | |
| Corporate Director |
Oct 1, 2019 | ||
| Aspirus, Inc |
5% Or Greater Indirect Ownership Interest | Mar 1, 2001 | 100% |
| 5% Or Greater Direct Ownership Interest | Oct 2, 2017 | 100% | |
| Dale Hustedt |
Corporate Officer |
Jul 2, 2018 | |
| W-2 Managing Employee |
Jul 2, 2018 | ||
| W-2 Managing Employee | Jul 2, 2018 | ||
| Operational/Managerial Control | Jul 2, 2018 | ||
| Rachel a Dixon |
Corporate Director |
Jan 17, 2018 | |
| Corporate Officer |
Jan 17, 2018 | ||
| Leonard W Hamman |
Corporate Director |
Jul 26, 2016 | |
| Corporate Director | Jul 26, 2016 | ||
| Greg Shaw |
Corporate Director | Apr 13, 2015 | |
| W-2 Managing Employee |
Apr 13, 2015 | ||
| Corporate Director | Apr 30, 2015 | ||
| Lori Peck |
Corporate Director |
Sep 30, 2015 | |
| W-2 Managing Employee |
Sep 30, 2015 | ||
| Operational/Managerial Control |
Sep 30, 2015 | ||
| Corporate Director |
Sep 30, 2015 | ||
| Tyler Hack |
Corporate Director |
Feb 26, 2024 | |
| W-2 Managing Employee |
Feb 26, 2024 | ||
| Operational/Managerial Control |
Feb 26, 2024 | ||
| Diane M Anderson |
Corporate Director |
Oct 1, 2022 | |
| Matthew F Heywood |
Corporate Director |
Jul 31, 2013 | |
| W-2 Managing Employee |
Jul 31, 2013 | ||
| Operational/Managerial Control |
Jul 31, 2013 | ||
| Corporate Officer | Jul 31, 2013 | ||
| W-2 Managing Employee | Jul 31, 2013 | ||
| Operational/Managerial Control | Jul 31, 2013 | ||
| Courtney Graff |
Corporate Director |
Oct 1, 2021 | |
| James Matheson |
Corporate Director |
Oct 1, 2020 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040129000007 | WI | Part B Supplier - Clinic/Group Practice | 5799688602 |
Receives reassigned benefits from 383 practitioners 6 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Medford, WI; Rib Lake, WI; Prentice, WI; Phillips, WI; Athens, WI; Gilman, WI |
| O20071211000401 | WI | Part a Provider - Critical Access Hospital | 5799688602 |
Receives reassigned benefits from 334 practitioners 7 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Prentice, WI; Gilman, WI; Athens, WI; Medford, WI |
| O20170914002531 | WI | Part a Provider - Rural Health Clinic | 5799688602 | Practice locations: Athens, WI |
National Provider Directory
- Tax ID family
- Aspirus Medford Hospital C
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | |||
| Clinic/Center | 261Q00000X | |||
| Rural Health Clinic/Center | 261QR1300X | Yes |
Addresses
Primary practice location
729 Pine St
Athens, WI 54411-9305
Mailing address
729 Pine St
Athens, WI 54411-9305
Phone (715) 748-8100
Other names
- Aspirus Athens Clinic
Other providers in Athens, WI
- Athenian Living, LLC
- Athens Area Fire Commission
- Rose Marie Bolinger
- Cynthia M Conway
- Steven R Conway
All providers in Athens, WI · Rural Health Clinic/Center in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 26, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.