Langlade Hospital - Hotel Dieu of St. Joseph of Antigo Wisconsin
Organization Active NPI Medicare Defined Swing Bed Hospital Unit · Antigo, WI
NPI 1801950746 · NPPES record last updated Feb 26, 2026
Key facts
- NPI
- 1801950746
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Medicare Defined Swing Bed Hospital Unit 275N00000X
- License
- 1055 (WI)
- Legal business name
- LANGLADE HOSPITAL - HOTEL DIEU OF ST. JOSEPH OF ANTIGO WISCONSIN
- Practice address
- 112 E 5TH Ave
Antigo, WI 54409-2710 - Phone
- (715) 623-2331
- NPI assigned
- Dec 21, 2006
- Organization subpart
- No
Authorized official
- Name
- Lori Peck
- Title
- SVP- Chief Financial Officer
- Phone
- (715) 847-2575
Owners & managing parties with NPI records 2
-
Lakshmi Deep, MD
-
Roshini Ann Samuel, M.D
Other NPIs with the same Medicare PAC ID 6
Corporate family (same tax ID) 8
Related certifications (CCN) 2
Facilities with the same owner 79
Practitioners 86
-
Alaina Below, FNP-BC
-
Angela Buchman, PA
-
Michael J Darr, ANP
-
Lakshmi Deep, MD
-
Noel N Deep, MD
-
Kyle Dembowiak, MD
-
Gregory G Dodge, MD
-
Kelly Jonathon Douck, CRNA
-
Melissa Ferg, CRNA
-
Samantha J Fox, APNP
-
Kara Hall, LCSW
-
Angela Haroldson, PMHNP
-
Sarah Kathryn Houdek, APNP
-
Hema Kamthamneni, M.D.
-
Jennifer J Lee, APNP
-
Nathaniel Joseph Retrum, PA-C
-
Calla J Scheel, APNP, PMHNP
Affiliated clinicians 1
-
Sara Belle Starr, APNP
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
Hospital certification: CCN 52Z350
- Legal name
- LANGLADE HOSPITAL - HOTEL DIEU OF ST JOSEPH OF ANTIGO WISCONSIN
- Doing business as
- LANGLADE HOSPITAL
- Organization structure
- Corporation · Non-profit
- Incorporated
- Jan 11, 1933 in WI
- Enrollment address
- 112E 5TH Ave
Antigo, WI 54409-2710
All disclosed owners & managing parties 15
| Name | Role | Since | Share |
|---|---|---|---|
| Julie a Sprague |
Corporate Director |
Sep 30, 2022 | |
| Jerry M Yang |
Corporate Director |
Feb 26, 2024 | |
| W-2 Managing Employee |
Feb 26, 2024 | ||
| Operational/Managerial Control |
Feb 26, 2024 | ||
| Lakshmi Deep |
Corporate Director |
Oct 1, 2023 | |
| Aspirus, Inc |
5% Or Greater Direct Ownership Interest | Jul 1, 2008 | 45% |
| James Matheson |
Corporate Director |
Sep 30, 2020 | |
| Religious Hospitallers of St. Joseph |
5% Or Greater Direct Ownership Interest | Jul 1, 2008 | 55% |
| John R Myers |
Corporate Director |
Sep 30, 2022 | |
| Lynne Henricks |
Corporate Director |
Sep 30, 2022 | |
| Mark Westen |
Corporate Director |
Oct 1, 2023 | |
| Lori Peck |
Corporate Director |
Sep 30, 2015 | |
| W-2 Managing Employee |
Sep 30, 2015 | ||
| Operational/Managerial Control |
Sep 30, 2015 | ||
| Roshini Samuel |
Corporate Director |
Sep 30, 2021 | |
| Sherry Bunten |
Corporate Officer |
Mar 20, 2021 | |
| W-2 Managing Employee |
Mar 20, 2021 | ||
| Tyler Hack |
Corporate Director |
Feb 26, 2024 | |
| W-2 Managing Employee |
Feb 26, 2024 | ||
| Operational/Managerial Control |
Feb 26, 2024 | ||
| Michael B Winter |
Corporate Director |
Jan 1, 2001 | |
| Matthew F Heywood |
Corporate Director |
Jul 31, 2013 | |
| W-2 Managing Employee |
Jul 31, 2013 | ||
| Operational/Managerial Control |
Jul 31, 2013 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20110208001061 | WI | Part a Provider - Critical Access Hospital | 1557271202 | Practice locations: Antigo, WI |
National Provider Directory
- Tax ID family
- Langlade Memorial Hosp
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medicare Defined Swing Bed Hospital Unit | 275N00000X | 1055 | WI | Yes |
Addresses
Primary practice location
112 E 5TH Ave
Antigo, WI 54409-2710
Mailing address
29980 Network PL
Chicago, IL 60673-1299
Phone (715) 847-2304
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 11018100 | Medicaid | WI |
Other providers in Antigo, WI
- Langlade Hospital - Hotel Dieu of St. Joseph of Antigo Wisconsin
- Langlade Hospital - Hotel Dieu of St. Joseph of Antigo Wisconsin
- Langlade Hospital - Hotel Dieu of St. Joseph of Antigo Wisconsin
- Langlade Hospital - Hotel Dieu of St. Joseph of Antigo Wisconsin
- Langlade Hospital - Hotel Dieu of St. Joseph of Antigo Wisconsin
- Langlade Hospital - Hotel Dieu of St. Joseph of Antigo Wisconsin
- Langlade Hospital - Hotel Dieu of St. Joseph of Antigo Wisconsin
- Langlade Memorial Hospital
- Nikole Lynn Larkin
- Karla Marie Larson
All providers in Antigo, WI · Medicare Defined Swing Bed Hospital Unit 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.