Active NPI
Langlade Hospital - Hotel Dieu of St. Joseph of Antigo Wisconsin
- Anesthesiology Physician
- Antigo, WI
National Provider Identifier
1891741195
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- 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
- May 26, 2006
- Last updated
- Feb 26, 2026
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Lori Peck
- Title
- SVP- Chief Financial Officer
- Phone
- (715) 847-2575
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | Primary | ||
| Pain Medicine (Anesthesiology) Physician | 207LP2900X |
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 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 21259500 | Medicaid | WI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040212000310 | WI | Part B Supplier - Clinic/Group Practice | 1557271202 |
Receives reassigned benefits from 353 practitioners 6 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Merrill, WI; Wittenberg, WI; Rhinelander, WI; Elcho, WI; Birnamwood, WI; Antigo, WI |
Other NPIs on the same Medicare enrollment 6
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
-
dba Aspirus Rhinelander Clinic
- Clinic/Center
- Rhinelander, WI
- NPI 1679757751
O20040212000310
-
dba Aspirus Birnamwood Clinic
- Rural Health Clinic/Center
- Birnamwood, WI
- NPI 1063574184
O20040212000310
-
dba Aspirus Antigo Clinic
- Rural Health Clinic/Center
- Antigo, WI
- NPI 1821151366
O20040212000310
-
dba Aspirus Elcho Clinic
- Rural Health Clinic/Center
- Elcho, WI
- NPI 1831251040
O20040212000310
-
- Critical Access Hospital
- Antigo, WI
- NPI 1639187412
O20040212000310
-
- Clinic/Center
- Wausau, WI
- NPI 1871630863
O20040212000310
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148601600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1772064000000",
"number": "1891741195",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "29980 NETWORK PL",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606731299",
"telephone_number": "715-847-2304",
"fax_number": "715-843-1188"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "112 E 5TH AVE",
"city": "ANTIGO",
"state": "WI",
"postal_code": "544092710",
"telephone_number": "715-623-2331"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LANGLADE HOSPITAL - HOTEL DIEU OF ST. JOSEPH OF ANTIGO WISCONSIN",
"organizational_subpart": "NO",
"enumeration_date": "2006-05-26",
"last_updated": "2026-02-26",
"certification_date": "2026-02-26",
"status": "A",
"authorized_official_last_name": "PECK",
"authorized_official_first_name": "LORI",
"authorized_official_title_or_position": "SVP- CHIEF FINANCIAL OFFICER",
"authorized_official_telephone_number": "715-847-2575"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Anesthesiology",
"state": null,
"license": null,
"primary": true
},
{
"code": "207LP2900X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Anesthesiology, Pain Medicine",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "21259500",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}
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 (Aspirus Langlade Hospital Leroyer Hospice)
- Langlade Memorial Hospital
- Nikole Lynn Larkin, NP
- Karla Marie Larson, PT
- Stephen Larson, CRNA
- Christina Leslie
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2026; 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.