NPIMap

Organization Active NPI

Moundview Memorial Hospital & Clinics, Inc.

Doing business as Gundersen Moundview Hospital and Clinics, Inc.

  • Rural Health Clinic/Center
  • Friendship, WI
National Provider Identifier
1962560334
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
MOUNDVIEW MEMORIAL HOSPITAL & CLINICS, INC.
Doing business as
Gundersen Moundview Hospital and Clinics, Inc.
Practice address
402 W. Lake St.
Friendship, WI 53934
Phone
(608) 339-3331
NPI assigned
Dec 5, 2006
Last updated
Jul 13, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
MOUNDVIEW MEMORIAL HOSPITAL & CLINICS, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Authorized official

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

Specialties & licenses 2

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

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 names 1

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

Medicare participation

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

Enrollment records 2

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

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1962560334. Details of each certification follow.

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
CorporationNon-profit
Incorporated
Jul 29, 1954 in WI
Enrollment address
402 W Lake St
Friendship, WI 53934-9699
Related CCNs
521309

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

Other NPIs with the same Medicare PAC ID 4

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

Other NPIs on the same Medicare enrollment 3

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

National Provider Directory

National Provider Directory
Part of
Adams County Mem Hospit

Ownership & related parties

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 DirectorCeo/Administrator Jan 31, 2026
Tadd Wormet Individual Corporate Director Feb 1, 2022
Michael Eckstein Individual Corporate DirectorBoard Member Jan 1, 2026
Eric Dehn Individual Corporate DirectorBoard Member Jan 1, 2026
Jennifer Parr Individual Corporate DirectorBoard 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 EmployeeLocal Integrity Officer Dec 12, 2011
Gundersen Lutheran Health System Inc Organization, La Crosse, WI Corporation, Non-profit Operational/Managerial Control Oct 1, 2017

Owners & managing parties with NPI records 1

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

Facilities with the same owner 49

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

View all 49

Practitioners & affiliated clinicians

Practitioners 70

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 70

NPI Registry JSON

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

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1783900800000",
    "number": "1962560334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "402 W. LAKE ST.",
            "address_2": "P.O. BOX 40",
            "city": "FRIENDSHIP",
            "state": "WI",
            "postal_code": "53934",
            "telephone_number": "608-339-3331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 W. LAKE ST.",
            "city": "FRIENDSHIP",
            "state": "WI",
            "postal_code": "53934",
            "telephone_number": "608-339-3331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNDVIEW MEMORIAL HOSPITAL & CLINICS, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MOUNDVIEW MEMORIAL HOSPITAL & CLINICS, INC.",
        "enumeration_date": "2006-12-05",
        "last_updated": "2026-07-13",
        "certification_date": "2026-07-13",
        "status": "A",
        "authorized_official_last_name": "WITTIG",
        "authorized_official_first_name": "LORI",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "608-339-8318"
    },
    "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
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gundersen Moundview Hospital and Clinics, Inc.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Friendship, WI

Sources for this page

Verify at the official NPI Registry.