Aspirus Eagle River Hospital, Inc
Organization Active NPI Land Ambulance · Eagle River, WI
NPI 1790718542 · NPPES record last updated Jun 7, 2024
Key facts
- NPI
- 1790718542
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Land Ambulance 3416L0300X
- Legal business name
- ASPIRUS EAGLE RIVER HOSPITAL, INC
- Practice address
- 201 Hospital Rd
Eagle River, WI 54521-8835 - Phone
- (715) 479-7411
- NPI assigned
- Jul 7, 2006
- Organization subpart
- Yes
- Parent organization (as reported)
- ASPIRUS EAGLE RIVER HOSPITAL, INC
Authorized official
- Name
- Jerry M Yang
- Title
- SVP & Chief Financial Officer
- Phone
- (715) 847-2526
Owners & managing parties with NPI records 2
-
Holly L Beede McKinney, APNP
Other NPIs on the same Medicare enrollment 2
Corporate family (same tax ID) 2
Related certifications (CCN) 1
Affiliated clinicians 105
-
Margaret Alvarez, NP
-
Katie Anderson, NP
-
Dawn E. Baker, MD
-
Olga Barchugova, MD
-
David Beck, M.D
-
Holly L Beede McKinney, APNP
-
Steven Brooks, MD
-
Steven R Brown, MD
-
Jill K Brunstad, PA
-
Benjamin Brusch, M.D.
-
Richard Kenneth Clark, PA-C
-
Erika Crockford, D.O.
-
Jonathan Currie, M.D.
-
Stacey M. Fashingbauer, PA-C, LAT
-
Colleen Fraley, APNP
-
Austin Gilbert, NURSE PRACTITIONER
-
Ashley Grill, FNP
-
Jamie Christine Hanrahan, RN, APNP
Medicare Care Compare: Hospital
- Listed as
- Aspirus Eagle River Hospital
- Type
- Critical Access Hospitals
- Ownership
- Voluntary non-profit - Private
- Medicare certification status
- Active
- Emergency services
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
Hospital certification: CCN 521300
- Legal name
- ASPIRUS EAGLE RIVER HOSPITAL & CLINICS, INC
- Doing business as
- ASPIRUS EAGLE RIVER HOSPITAL
- Certification status
- Active
- Provider type (POS)
- Hospital – Critical access hospital
- Participating since
- Oct 1, 1999
- Last certification
- Sep 22, 2022
- Beds
- 25
- Ownership / control type
- Private (not for profit)
- Organization structure
- Corporation · Non-profit
- Incorporated
- Oct 2, 1961 in WI
- Enrollment address
- 201 Hospital Rd
Eagle River, WI 54521-8835
All disclosed owners & managing parties 15
| Name | Role | Since | Share |
|---|---|---|---|
| Michael Holzhueter |
Corporate Director |
Aug 1, 2021 | |
| Jerry M Yang |
Corporate Director |
Feb 26, 2024 | |
| W-2 Managing Employee |
Feb 26, 2024 | ||
| Operational/Managerial Control |
Feb 26, 2024 | ||
| Holly L Beede-McKinney |
Corporate Director |
Aug 1, 2021 | |
| Aspirus, Inc |
5% Or Greater Direct Ownership Interest | Aug 1, 2021 | 100% |
| Kelly L Court |
Corporate Director |
Jul 1, 2019 | |
| Teresa J Theiler |
W-2 Managing Employee | Jan 1, 2022 | |
| Operational/Managerial Control | Jan 1, 2022 | ||
| Amy Vanney |
Corporate Director |
Oct 1, 2023 | |
| Eric J Anderson |
Corporate Director |
Aug 1, 2021 | |
| Ronald Patterson |
Corporate Director |
Oct 1, 2023 | |
| Judith a Crouch-Smolarek |
Corporate Director |
Aug 1, 2021 | |
| Ryan Huseby |
Corporate Director |
Oct 1, 2023 | |
| Lori Peck |
Corporate Director |
Dec 1, 2021 | |
| W-2 Managing Employee |
Dec 1, 2021 | ||
| Operational/Managerial Control |
Dec 1, 2021 | ||
| Tyler Hack |
Corporate Director |
Feb 26, 2024 | |
| W-2 Managing Employee |
Feb 26, 2024 | ||
| Operational/Managerial Control |
Feb 26, 2024 | ||
| Arthur C Helgerson |
Corporate Director |
Mar 1, 2013 | |
| Matthew F Heywood |
Corporate Officer |
Aug 1, 2021 | |
| W-2 Managing Employee |
Aug 1, 2021 | ||
| Operational/Managerial Control |
Aug 1, 2021 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20061104000603 | WI | Part a Provider - Critical Access Hospital | 1658361951 |
Receives reassigned benefits from 1 practitioner 2 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Eagle River, WI |
National Provider Directory
- Tax ID family
- Eagle River Memorial Hospital
- Part of
- Eagle River Memorial Hospital
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Critical Access Hospital | 282NC0060X | 1000 | WI | |
| Land Ambulance | 3416L0300X | WI | Yes |
Addresses
Primary practice location
201 Hospital Rd
Eagle River, WI 54521-8835
Mailing address
29980 Network PL
Chicago, IL 60673-1299
Phone (715) 847-2304
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 41341400 | Medicaid | WI |
Other names
- Aspirus Eagle River Hospital
Other providers in Eagle River, WI
- Jennifer R Alward
- Amelia Andacht
- Aspirus Eagle River Hospital & Clinics, Inc
- Aspirus Eagle River Hospital & Clinics, Inc.
- Aspirus Eagle River Hospital & Clinics, Inc.
- Aspirus Eagle River Hospital, Inc.
- Aspirus Rhinelander & Tomahawk Hospitals & Clinics, Inc.
- Lawvet Fonbah Asukwa
- Randall L Athens
- Kris Ann Barnekow
All providers in Eagle River, WI · Land Ambulance in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 7, 2024. 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.