NPIMap

Organization Active NPI

Sauk Prairie Healthcare Inc

Doing business as Sauk Prairie Healthcare Campus Clinic

  • Family Medicine Physician
  • Prairie Du Sac, WI
National Provider Identifier
1841932159
Registry record updated Apr 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
SAUK PRAIRIE HEALTHCARE INC
Doing business as
Sauk Prairie Healthcare Campus Clinic
Practice address
250 26TH St
Prairie Du Sac, WI 53578-2203
Phone
(608) 643-3000
NPI assigned
Apr 8, 2022
Last updated
Apr 22, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2022

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

Authorized official

Name
James Dregney
Title
Cfo/Vice President
Phone
(608) 643-7212

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

250 26TH St
Prairie Du Sac, WI 53578-2203

Mailing address

260 26TH St
Prairie Du Sac, WI 53578-2203
Phone (608) 643-7171

Other names 1

  • Sauk Prairie Healthcare Campus Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031208000206 WI Part B Supplier - Clinic/Group Practice 8224948054 Receives reassigned benefits from 145 practitioners
13 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Lodi, WI; Mazomanie, WI; Plain, WI; Prairie Du Sac, WI; Sauk City, WI; Spring Green, WI

Other NPIs on the same Medicare enrollment 13

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 13

National Provider Directory

National Provider Directory
Tax ID family
Sauk Prairie Memorial H9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

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

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1649376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1650585600000",
    "number": "1841932159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "260 26TH ST",
            "city": "PRAIRIE DU SAC",
            "state": "WI",
            "postal_code": "535782203",
            "telephone_number": "608-643-7171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 26TH ST",
            "city": "PRAIRIE DU SAC",
            "state": "WI",
            "postal_code": "535782203",
            "telephone_number": "608-643-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAUK PRAIRIE HEALTHCARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-08",
        "last_updated": "2022-04-22",
        "certification_date": "2022-04-13",
        "status": "A",
        "authorized_official_last_name": "DREGNEY",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "CFO/VICE PRESIDENT",
        "authorized_official_telephone_number": "608-643-7212"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sauk Prairie Healthcare Campus Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Sauk Prairie Healthcare Campus Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Prairie Du Sac, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.