NPIMap

Organization Active NPI

Beaver Dam Community Hospitals Inc

Doing business as Hillside Hospice

  • Community Based Hospice Care Agency
  • Beaver Dam, WI
National Provider Identifier
1962463760
Registry record updated Jul 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
License
1518 Issued in WI
Legal business name
BEAVER DAM COMMUNITY HOSPITALS INC
Doing business as
Hillside Hospice
Practice address
707 S University Ave
Beaver Dam, WI 53916-3027
Phone
(920) 887-4050
NPI assigned
Mar 31, 2006
Last updated
Jul 18, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
MARSHFIELD CLINIC HEALTH SYSTEM INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 18, 2025

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

Authorized official

Name
Jolyn Munson
Title
VP Revenue Cycle Operations
Phone
(605) 328-6585

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X 1518 WI Primary

Addresses

Primary practice location

707 S University Ave
Beaver Dam, WI 53916-3027

Mailing address

1000 N Oak Ave
Provider Enrollment Services - SHP FL 2
Marshfield, WI 54449-5703

Other names 1

  • Hillside Hospice Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070214000067 WI Part A Provider - Hospice 2567370539 Practice locations: Beaver Dam, WI

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1962463760. Details of each certification follow.

Hospice certification: CCN 521518

Legal name
BEAVER DAM COMMUNITY HOSPITALS INC.
Doing business as
HILLSIDE HOSPICE
Certification status
Active
Provider type (POS)
Hospice
Participating since
Apr 13, 1988
Last certification
Feb 9, 2022
Ownership / control type
Non-Profit - Private
Organization structure
CorporationNon-profit
Incorporated
Feb 28, 1972 in WI
Enrollment address
707 S University Ave
Beaver Dam, WI 53916-3027

Other NPIs with the same Medicare PAC ID 8

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

Care Compare: Hospice

Medicare Care Compare
Listed as
Hillside HospiceCCN 521518 · All quality measures
Ownership
Non-Profit
Certified
Apr 13, 1988
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory
Tax ID family
Beaver Dam Comm Hospita9 organizations share this tax ID, including this one
Part of
Marshfield Clinic Health System Inc

Other organizations with this tax ID 8

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

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

  • MCHS Hospitals Inc

    dba MCHS Freestanding Clinic Physician Group

    • Internal Medicine Physician
    • Wausau, WI
    • NPI 1164159109

    Member Of

    NPD member

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
Brian D Hoerneman Individual Corporate OfficerPresident, Ceo Apr 4, 2023
Corporate DirectorBoard Member Sep 1, 2023
Tony Lee Morrison Individual W-2 Managing EmployeeVP, Chief Revenue Officer Jan 1, 2025
John F Baltus Individual Corporate OfficerVice Chair/ Secretary /Treasurer Sep 8, 2023
Corporate DirectorBoard Member Feb 4, 2016
Lindsey a Buswell Cleary Individual W-2 Managing EmployeeMD; Dec 1, 2023
Jolyn Joy Munson Individual W-2 Managing EmployeeVP Revenue Cycle Operations Jan 1, 2025
Dennis H Smith Individual Corporate Director Jan 14, 2025
Jeffrey Douglas Poppen Individual Corporate OfficerCfo - MCHS Region Jun 12, 2025
W-2 Managing EmployeeCfo - MCHS Region Jun 12, 2025
Edward G Fernandez Individual Corporate OfficerChair / Board Member Jan 1, 2025
Corporate DirectorBoard Member Sep 8, 2023
Kelly Danner Individual W-2 Managing EmployeeAd; Jul 11, 2025
Operational/Managerial ControlHospice Administrator Jul 11, 2025
MCHS Hospitals Inc Organization, Marshfield, WI Corporation, Non-profit 5% Or Greater Direct Ownership Interest May 1, 2019 100%
Samantha L Klebe Individual Corporate DirectorBoard Member Sep 8, 2023
W-2 Managing EmployeeChief Physician Jan 1, 2025
Linda Laverne Procci Individual Corporate Director Feb 1, 2025
Sanford Organization, Fargo, ND Corporation, Non-profit, Chain home office 5% Or Greater Indirect Ownership Interest Jan 1, 2025
Everett W Newcomb Individual Corporate DirectorBoard Member Sep 13, 2024
Marshfield Clinic Health System Inc Organization, Marshfield, WI Non-profit 5% Or Greater Indirect Ownership Interest May 1, 2019 100%
Douglas Mathison Individual Corporate DirectorBoard Member Dec 15, 2020
Nicholas Wayne Olson Individual W-2 Managing EmployeeCfo - Sanford, Executive VP Jan 1, 2025

Owners & managing parties with NPI records 4

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

Facilities with the same owner 41

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

View all 41

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Affiliated clinicians 6

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1143763200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1752796800000",
    "number": "1962463760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 N OAK AVE",
            "address_2": "PROVIDER ENROLLMENT SERVICES - SHP FL 2",
            "city": "MARSHFIELD",
            "state": "WI",
            "postal_code": "544495703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 S UNIVERSITY AVE",
            "city": "BEAVER DAM",
            "state": "WI",
            "postal_code": "539163027",
            "telephone_number": "920-887-4050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEAVER DAM COMMUNITY HOSPITALS INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MARSHFIELD CLINIC HEALTH SYSTEM INC",
        "enumeration_date": "2006-03-31",
        "last_updated": "2025-07-18",
        "certification_date": "2025-07-18",
        "status": "A",
        "authorized_official_last_name": "MUNSON",
        "authorized_official_first_name": "JOLYN",
        "authorized_official_title_or_position": "VP REVENUE CYCLE OPERATIONS",
        "authorized_official_telephone_number": "605-328-6585"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "WI",
            "license": "1518",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hillside Hospice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Beaver Dam, WI

Sources for this page

Verify at the official NPI Registry.