St. Joseph'S Health Services, Inc
Organization Active NPI Rural Health Clinic/Center · Wonewoc, WI
NPI 1881607463 · NPPES record last updated May 7, 2012
Key facts
- NPI
- 1881607463
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Rural Health Clinic/Center 261QR1300X
- Legal business name
- ST. JOSEPH'S HEALTH SERVICES, INC
- Practice address
- 301 Railroad Rd
Wonewoc, WI 53968-9425 - Phone
- (608) 464-3575
- Fax
- (608) 464-3576
- NPI assigned
- Aug 14, 2006
- Organization subpart
- No
Authorized official
- Name
- Ms. Pamela K Dewitt
- Title
- Cfo
- Phone
- (608) 489-8103
Other NPIs on the same Medicare enrollment 4
Other NPIs with the same Medicare PAC ID 4
Corporate family (same tax ID) 5
Related certifications (CCN) 1
Facilities with the same owner 49
Practitioners 120
-
Mateen Fatima Abidi, M.D
-
Andrea L Anderson, PA-C
-
Carrie L Brilowski, APNP
-
Zachary Ronald Clements, D.O.
-
Jordan L Ludwigson, M.D.
-
Michael A Witcik, MD
-
Raju G Ailiani, MD
-
Keith Edward Baynes, M.D.
-
Marcus William Bickford, M.D.
-
William Adam Bishop, M.D.
-
Rebecca L Blank, PA
-
Christina M Brooks, MSW APSW
-
Ward M Brown, MD
-
Ross Michael Cerniglia, M.D.
-
Christine A Dean, LCSW
-
Murray Sean Donovan, M.D.
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 52D0394204 | St Joseph'S Health Services, Inc | Certificate of waiver | Jul 31, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in WI
Rural health clinic certification: CCN 528539
- Legal name
- ST JOSEPH'S HEALTH SERVICES INC
- Doing business as
- GUNDERSEN ST. JOSEPH'S HOSPITAL AND CLINICS
- Certification status
- Active
- Provider type (POS)
- Rural health clinic
- Participating since
- Jul 1, 2011
- Last certification
- May 13, 2025
- Ownership / control type
- 2B
- Organization structure
- Corporation · Non-profit
- Incorporated
- Jun 6, 1949 in WI
- Enrollment address
- 301 Railroad Rd
Wonewoc, WI 53968-9425 - Related CCNs
- 521304
All disclosed owners & managing parties 14
| Name | Role | Since | Share |
|---|---|---|---|
| Natalie Adams |
Corporate Director |
Jan 1, 2021 | |
| Jennifer Boigenzahn |
Corporate Officer |
Mar 31, 2025 | |
| W-2 Managing Employee |
Feb 1, 2026 | ||
| Dana Meyers |
Corporate Director |
Oct 1, 2020 | |
| Ann M Brandau-Hynek |
Corporate Director |
Jul 1, 2011 | 9% |
| Bellin Gundersen Health System Inc |
5% Or Greater Indirect Ownership Interest | Nov 30, 2022 | 100% |
| Operational/Managerial Control | Nov 30, 2022 | ||
| Kraig Schuster |
Corporate Officer |
Feb 1, 2026 | |
| Jon Woolever |
Corporate Director |
Jan 18, 2024 | |
| Michael McKee |
Corporate Director | Jun 21, 2018 | |
| Jeri Weger |
Corporate Director |
Apr 17, 2025 | |
| Gundersen Lutheran Health System Inc |
5% Or Greater Direct Ownership Interest | Jul 1, 2011 | 100% |
| Operational/Managerial Control | Jul 1, 2011 | ||
| Annette Lechnir |
Corporate Director | Jan 1, 2023 | |
| Hannah Young |
Corporate Officer |
Jun 1, 2026 | |
| Stacie Christensen |
Corporate Director | Feb 1, 2022 | |
| Holly Boisen |
Corporate Director | Jan 1, 2023 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040615000273 | WI | Part B Supplier - Clinic/Group Practice | 3971586439 |
Receives reassigned benefits from 307 practitioners 4 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Wonewoc, WI; Whitehall, WI; Viroqua, WI; Prairie Du Chien, WI; Onalaska, WI; Mequon, WI; Madison, WI; La Crosse, WI… |
| O20110810000560 | WI | Part a Provider - Rural Health Clinic | 3971586439 |
1 other NPI on this enrollment Practice locations: Wonewoc, WI |
National Provider Directory
- Tax ID family
- St Joseph'S Health Services Inc
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rural Health Clinic/Center | 261QR1300X | WI | Yes |
Addresses
Primary practice location
301 Railroad Rd
Wonewoc, WI 53968-9425
Mailing address
PO Box 527
Hillsboro, WI 54634-0527
Phone (608) 489-8000
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P10 | Other | WI | DEAN HEALTH PLAN |
| 78B97JO | Other | WI | ATRIUM |
| 78B97JO | Other | MN | BCBS MINNESOTA |
| 100019417 | Medicaid | WI |
Other names
- St. Joseph's Health Services - Wonewoc Clinic
Other providers in Wonewoc, WI
- Valerie Madsen
- Maria Miller
- Deanna Jean Moore
- Natasha Ragan
- Kaitlyn Skaro
- James Donald Thompson
- Leslie Weber
- Wonewoc Area Fire and Ambulance Association, Inc.
- Wonewoc Union Center School District
All providers in Wonewoc, 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 May 7, 2012. 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.