Flambeau Hospital Inc
Organization Active NPI Rural Health Clinic/Center · Phillips, WI
NPI 1902493976 · NPPES record last updated Jun 18, 2026
Key facts
- NPI
- 1902493976
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Rural Health Clinic/Center 261QR1300X
- Legal business name
- FLAMBEAU HOSPITAL INC
- Practice address
- 104 Trinity Dr
Phillips, WI 54555-1524 - Phone
- (715) 339-2101
- NPI assigned
- Dec 24, 2020
- Organization subpart
- Yes
- Parent organization (as reported)
- MARSHFIELD CLINIC HEALTH SYSTEM INC
Authorized official
- Name
- Jolyn Munson
- Title
- VP Revenue Cycle Operations
- Phone
- (605) 328-6585
Parent organization (reported in NPPES) 1
Owners & managing parties with NPI records 3
-
Brian Hoerneman, MD
Other NPIs with the same Medicare PAC ID 5
Corporate family (same tax ID) 4
Member of 1
Related certifications (CCN) 1
Facilities with the same owner 41
Practitioners 40
-
Gavin Mark Ambrosi, M.D.
-
Lee A Anderson, MD
-
Trista J Barlow, APNP
-
Alexandra Bice, LPC
-
Jaime Alberto Boero, MD PHD
-
Alexa Boersen, PA-C
-
Melissa Bohn, FNP
-
Gabriel Buechel, DNP
-
Louay O Danial, MD
-
Allyson Jane Darga, M.D.
-
Karly Eckes, PAC
-
Joseph Edmund, M.B.B.S
-
Jan Anthony Goral, M.D.
-
Ross Taylor Groeschl, DPM
-
Jamie Christine Hanrahan, RN, APNP
-
Yusuf Kasirye, M.D.
-
Jennifer Kay Ledferd, LPC
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 52D0395935 | Marshfield Clinic Phillips Center | Certificate of waiver | Feb 18, 2028 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
Rural health clinic certification: CCN 528619
- Legal name
- FLAMBEAU HOSPITAL, INC.
- Doing business as
- MARSHFIELD CLINIC PHILLIPS CENTER
- Certification status
- Active
- Provider type (POS)
- Rural health clinic
- Participating since
- Mar 15, 2021
- Last certification
- Mar 15, 2021
- Ownership / control type
- 2B
- Organization structure
- Corporation · Non-profit
- Enrollment address
- 104 Trinity Dr
Phillips, WI 54555-1524 - Related CCNs
- 521325
All disclosed owners & managing parties 15
| Name | Role | Since | Share |
|---|---|---|---|
| Brian D Hoerneman |
Corporate Officer |
Apr 4, 2023 | |
| Corporate Director |
Sep 1, 2023 | ||
| Tony Lee Morrison |
W-2 Managing Employee |
Jan 1, 2025 | |
| John F Baltus |
Corporate Officer |
Sep 8, 2023 | |
| Corporate Director |
Feb 3, 2016 | ||
| Jolyn Joy Munson |
W-2 Managing Employee |
Jan 1, 2025 | |
| Dennis H Smith |
Corporate Director |
Jan 14, 2025 | |
| Jeffrey Douglas Poppen |
Corporate Officer |
Jun 12, 2025 | |
| W-2 Managing Employee |
Jun 12, 2025 | ||
| Edward G Fernandez |
Corporate Officer |
Jan 1, 2025 | |
| Corporate Director |
Sep 9, 2023 | ||
| MCHS Hospitals Inc |
5% Or Greater Direct Ownership Interest | Aug 1, 2020 | 100% |
| Operational/Managerial Control | Aug 1, 2020 | 100% | |
| Samantha L Klebe |
Corporate Director |
Sep 8, 2023 | |
| W-2 Managing Employee |
Jan 1, 2025 | ||
| Linda Laverne Procci |
Corporate Director |
Feb 1, 2025 | |
| Sanford |
5% Or Greater Indirect Ownership Interest | Jan 1, 2025 | 100% |
| Everett W Newcomb |
Corporate Director |
Sep 13, 2024 | |
| Marshfield Clinic Health System Inc |
5% Or Greater Indirect Ownership Interest | Aug 1, 2020 | 100% |
| Operational/Managerial Control | Aug 1, 2020 | ||
| Douglas Mathison |
Corporate Director |
Dec 15, 2020 | |
| Nicholas Wayne Olson |
W-2 Managing Employee |
Jan 1, 2025 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20210105002456 | WI | Part a Provider - Rural Health Clinic | 9032029871 | Practice locations: Phillips, WI |
National Provider Directory
- Tax ID family
- Flambeau Hosp Inc-Crna
- Part of
- Marshfield Clinic Health System Inc
Locations
104 Trinity Dr
Phillips, WI 54555
Phone (715) 339-2101
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rural Health Clinic/Center | 261QR1300X | Yes |
Addresses
Primary practice location
104 Trinity Dr
Phillips, WI 54555-1524
Mailing address
1000 N Oak Ave
Provider Enrollment Services - SHP FL2
Marshfield, WI 54449-5703
Phone (715) 389-0668
Other names
- Marshfield Clinic Phillips Center
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service | Other | Cobius Healthcare Solutions |
Other providers in Phillips, WI
- Jennifer Renee Downing
- Karly Eckes
- Melanie M Eggebrecht
- Tully Erwin
- Kelly Jean Falk
- Nicholas John Franssen
- Dewane D. Frase
- Timothy A Gehrke
- Haven House
- Haven House Community Support Center LLC
All providers in Phillips, 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 Jun 18, 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.
- 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.