NPIMap

Organization Active NPI

Aspirus Medford Hospital & Clinics, Inc.

Doing business as Aspirus Phillips Clinic

  • Rural Health Clinic/Center
  • Phillips, WI
National Provider Identifier
1891971768
Registry record updated Feb 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
ASPIRUS MEDFORD HOSPITAL & CLINICS, INC.
Doing business as
Aspirus Phillips Clinic
Practice address
625 Peterson Av
Phillips, WI 54555-1430
Phone
(715) 339-4035
Fax
(715) 339-4036
NPI assigned
Jan 10, 2008
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
Lori Peck
Title
SVP- Chief Financial Officer
Phone
(715) 847-2575

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X
Rural Health Clinic/Center 261QR1300X Primary
Family Medicine Physician 207Q00000X

Addresses

Primary practice location

625 Peterson Av
Phillips, WI 54555-1430

Mailing address

135 S Gibson St
Medford, WI 54451-1622
Phone (715) 748-8100

Other names 1

  • ASPIRUS PHILLIPS CLINIC Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040129000007 WI Part B Supplier - Clinic/Group Practice 5799688602 Receives reassigned benefits from 383 practitioners
6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Medford, WI; Rib Lake, WI; Prentice, WI; Phillips, WI; Athens, WI; Gilman, WI
O20100422000204 WI Part A Provider - Rural Health Clinic 5799688602 Practice locations: Phillips, WI

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1891971768. Details of each certification follow.

Rural health clinic certification: CCN 528537

Legal name
ASPIRUS MEDFORD HOSPITAL & CLINICS INC
Doing business as
ASPIRUS PHILLIPS CLINIC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Aug 11, 2011
Last certification
Sep 10, 2025
Ownership / control type
2B
Organization structure
CorporationNon-profit
Incorporated
Jun 2, 1958 in WI
Enrollment address
625 Peterson Ave
Phillips, WI 54555-1452
Related CCNs
521324

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

Other NPIs with the same Medicare PAC ID 8

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

Other NPIs on the same Medicare enrollment 6

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

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
52D2006824Aspirus Phillips Clinic625 Peterson Ave, Phillips, WI 54555Certificate of waiverSep 30, 2026

National Provider Directory

National Provider Directory
Tax ID family
Aspirus Medford11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

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

Ownership & related parties

All disclosed owners & managing parties 17

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

NameRoleSinceShare
Jeffrey Koenig Individual Corporate DirectorBoard Member Nov 1, 2023
Michael Holzhueter Individual Corporate DirectorBoard Member Oct 1, 2019
Courtney Graff Individual Corporate DirectorBoard Member Oct 1, 2021
Jerry M Yang Individual Corporate DirectorSVP and Chief Financial Officer Feb 26, 2024
W-2 Managing EmployeeSVP and Chief Financial Offic Feb 26, 2024
Operational/Managerial ControlSVP and Chief Financial Officer Feb 26, 2024
Randy Juedes Individual Corporate DirectorBoard Member Oct 1, 2019
John Lange Individual Corporate DirectorBoard Member Oct 1, 2020
Susan M Schneider Individual Corporate DirectorBoard Member Oct 1, 2020
Aspirus, Inc Organization, Wausau, WI Corporation, Non-profit 5% Or Greater Direct Ownership Interest Mar 1, 2011 100%
James Matheson Individual Corporate DirectorVice-Chairperson Oct 1, 2020
Dale Hustedt Individual Corporate Director Jul 2, 2018
W-2 Managing Employee Jul 2, 2018
Operational/Managerial Control Jul 2, 2018
Rachel a Dixon Individual Corporate Director Jan 17, 2018
Leonard W Hamman Individual Corporate DirectorBoard Member Jul 26, 2016
Greg Shaw Individual Corporate Director Apr 13, 2015
W-2 Managing EmployeeVP Finance/Assistant Treasurer Apr 13, 2015
Lori Peck Individual Corporate DirectorVP - Finance Feb 26, 2024
W-2 Managing EmployeeVP-Finance Feb 26, 2024
Operational/Managerial ControlVP-Finance Feb 26, 2024
Tyler Hack Individual Corporate DirectorVP - Revenue Cycle Feb 26, 2024
W-2 Managing EmployeeVP - Revenue Cycle Feb 26, 2024
Operational/Managerial ControlVP - Revenue Cycle Feb 26, 2024
Diane M Anderson Individual Corporate DirectorBoard Member Oct 1, 2022
Matthew F Heywood Individual Corporate Officer Jul 31, 2013
W-2 Managing Employee Jul 31, 2013
Operational/Managerial Control Jul 31, 2013

Owners & managing parties with NPI records 3

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

Facilities with the same owner 79

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 79

Practitioners & affiliated clinicians

Practitioners 23

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 23

NPI Registry JSON

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

{
    "created_epoch": "1199923200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1772064000000",
    "number": "1891971768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 S GIBSON ST",
            "city": "MEDFORD",
            "state": "WI",
            "postal_code": "544511622",
            "telephone_number": "715-748-8100",
            "fax_number": "715-748-8199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 PETERSON AV",
            "city": "PHILLIPS",
            "state": "WI",
            "postal_code": "545551430",
            "telephone_number": "715-339-4035",
            "fax_number": "715-339-4036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASPIRUS MEDFORD HOSPITAL & CLINICS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-10",
        "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": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ASPIRUS PHILLIPS CLINIC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "ASPIRUS PHILLIPS CLINIC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Phillips, WI

Sources for this page

Verify at the official NPI Registry.