NPIMap

Organization Active NPI

Ladd Memorial Hospital

Doing business as Osceola Medical Center Osceola Clinic

  • Rural Health Clinic/Center
  • Osceola, WI
National Provider Identifier
1801394549
Registry record updated Feb 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
License
1021 Issued in WI
Legal business name
LADD MEMORIAL HOSPITAL
Practice address
2600 65TH Ave
Osceola, WI 54020-4370
Phone
(715) 294-2111
Fax
(715) 294-5758
NPI assigned
Jan 29, 2018
Last updated
Feb 26, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2026

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

Authorized official

Name
Kelly Elizabeth Macken-Marble
Title
Chief Executive Officer
Phone
(715) 294-5622

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X 1021 WI Primary

Addresses

Primary practice location

2600 65TH Ave
Osceola, WI 54020-4370

Mailing address

PO Box 218
Osceola, WI 54020-0218
Phone (715) 294-2111

Other names 1

  • Osceola Medical Center Osceola Clinic Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180309000995 WI Part A Provider - Rural Health Clinic 9931092848 Practice locations: Osceola, WI

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1801394549. Details of each certification follow.

Rural health clinic certification: CCN 528606

Legal name
LADD MEMORIAL HOSPITAL
Doing business as
OSCEOLA MEDICAL CENTER OSCEOLA CLINIC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Feb 8, 2019
Last certification
Feb 8, 2019
Ownership / control type
2B
Organization structure
CorporationNon-profit
Incorporated
Oct 10, 1947 in WI
Enrollment address
2600 65TH Ave
Osceola, WI 54020-4376
Related CCNs
521318

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

Other NPIs with the same Medicare PAC ID 2

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

National Provider Directory

National Provider Directory
Tax ID family
Ladd Memorial Hospital5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Locations

268 Griffin St E
Amery, WI 54001

Ownership & related parties

All disclosed owners & managing parties 4

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

NameRoleSinceShare
Kelly E Macken-Marble Individual Corporate OfficerCeo Jul 1, 2024
Kelsey Jo Finnegan Individual W-2 Managing EmployeeCredentialing Specialist Jun 30, 2003
Anne Marie Pueschner Individual Corporate Director Apr 1, 2018
Amanda N Tembreull Individual Corporate Director Apr 1, 2018
W-2 Managing Employee Apr 1, 2018

Owners & managing parties with NPI records 1

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

Practitioners & affiliated clinicians

Practitioners 110

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 110

NPI Registry JSON

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

{
    "created_epoch": "1517184000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1772064000000",
    "number": "1801394549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 218",
            "city": "OSCEOLA",
            "state": "WI",
            "postal_code": "540200218",
            "telephone_number": "715-294-2111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 65TH AVE",
            "city": "OSCEOLA",
            "state": "WI",
            "postal_code": "540204370",
            "telephone_number": "715-294-2111",
            "fax_number": "715-294-5758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LADD MEMORIAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-29",
        "last_updated": "2026-02-26",
        "certification_date": "2026-02-26",
        "status": "A",
        "authorized_official_last_name": "MACKEN-MARBLE",
        "authorized_official_first_name": "KELLY",
        "authorized_official_middle_name": "ELIZABETH",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "715-294-5622"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "WI",
            "license": "1021",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Osceola Medical Center Osceola Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Osceola Medical Center Osceola Clinic",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Osceola, WI

Sources for this page

Verify at the official NPI Registry.