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Moundview Memorial Hospital & Clinics, Inc.

Organization Active NPI Rural Health Clinic/Center · Friendship, WI

NPI 1962560334 · NPPES record last updated Jul 13, 2026

Key facts

NPI
1962560334
Entity type
Organization (NPI type 2)
Primary specialty
Rural Health Clinic/Center 261QR1300X
Legal business name
MOUNDVIEW MEMORIAL HOSPITAL & CLINICS, INC.
Practice address
402 W. Lake St.
Friendship, WI 53934
Phone
(608) 339-3331
NPI assigned
Dec 5, 2006
Organization subpart
Yes
Parent organization (as reported)
MOUNDVIEW MEMORIAL HOSPITAL & CLINICS, INC.

Authorized official

Name
Lori Wittig
Title
Administrator
Phone
(608) 339-8318

Owners & managing parties with NPI records 1

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

Other NPIs on the same Medicare enrollment 3

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

Other NPIs with the same Medicare PAC ID 4

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

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

Facilities with the same owner 49

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

View all 49

Practitioners 111

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 111

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in WI

Rural health clinic certification: CCN 528520

Legal name
MOUNDVIEW MEMORIAL HOSPITAL & CLINICS, INC.
Doing business as
GUNDERSEN MOUNDVIEW HOSPITAL AND CLINICS
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
May 13, 2002
Last certification
Jan 13, 2026
Ownership / control type
2B
Organization structure
Corporation · Non-profit
Incorporated
Jul 29, 1954 in WI
Enrollment address
402 W Lake St
Friendship, WI 53934-9699
Related CCNs
521309

All disclosed owners & managing parties 12

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

NameRoleSinceShare
Stephanie L Carroll
Individual 		Corporate Director Jul 13, 2020
Joseph Thiesen
Individual 		Corporate Director Jul 13, 2020
Lori Wittig
Individual 		Corporate Director
Ceo/Administrator		 Jan 31, 2026
Tadd Wormet
Individual 		Corporate Director Feb 1, 2022
Michael Eckstein
Individual 		Corporate Director
Board Member		 Jan 1, 2026
Eric Dehn
Individual 		Corporate Director
Board Member		 Jan 1, 2026
Jennifer Parr
Individual 		Corporate Director
Board Member		 Jan 1, 2025
Bellin Gundersen Health System Inc
Organization · La Crosse, WI
Corporation, Non-profit 		5% Or Greater Indirect Ownership Interest Nov 30, 2022
Operational/Managerial Control Nov 30, 2022
Laurie Inda
Individual 		Corporate Director Jan 1, 2023
Roxanne Potts
Individual 		Corporate Director May 1, 2019
Kurtis K Miller
Individual 		W-2 Managing Employee
Local Integrity Officer		 Dec 12, 2011
Gundersen Lutheran Health System Inc
Organization · La Crosse, WI
Corporation, Non-profit 		Operational/Managerial Control Oct 1, 2017

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20030401000026 WI Part a Provider - Rural Health Clinic 1355250432 1 other NPI on this enrollment
Practice locations: Friendship, WI
O20031121000846 WI Part B Supplier - Clinic/Group Practice 1355250432 Receives reassigned benefits from 300 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Friendship, WI; Westfield, WI

National Provider Directory

Part of
Moundview Memorial Hospital

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X
Rural Health Clinic/Center 261QR1300X Yes

Addresses

Primary practice location

402 W. Lake St.
Friendship, WI 53934

Mailing address

402 W. Lake St.
P.O. Box 40
Friendship, WI 53934
Phone (608) 339-3331

Other identifiers

IdentifierTypeStateIssuer
CR0660OtherWIMEDICARE RAILROAD
43061300MedicaidWI

Other names

  • Gundersen Moundview Hospital and Clinics, Inc. Doing business as

Other providers in Friendship, WI

All providers in Friendship, WI · Rural Health Clinic/Center in Wisconsin

Sources for this page

Verify at the official NPI Registry.