Beaver Dam Community Hospitals Inc
Organization Active NPI Clinic/Center · Beaver Dam, WI
NPI 1972188555 · NPPES record last updated Apr 14, 2026
Key facts
- NPI
- 1972188555
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Clinic/Center 261Q00000X
- Legal business name
- BEAVER DAM COMMUNITY HOSPITALS INC
- Practice address
- 707 S University Ave
Beaver Dam, WI 53916-3027 - Phone
- (920) 887-7181
- NPI assigned
- Mar 15, 2021
- 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
Other NPIs on the same Medicare enrollment 14
Other NPIs with the same Medicare PAC ID 8
Practitioners 1,565
-
Omar Abdelmegid, MD
-
Mesfin Taye Abera, M.D.
-
Shawn Douglas Antle, M.D.
-
Priya Asija, MD
-
Meghan Asleson, CRNA
-
Michelle J Bartzen, PA-C
-
Chloe Bille, MSPAS, PA-C
-
Megan G Bisson, CRNA
-
David Brad Bogard, CRNA
-
Shelby Ann Brandsma, LCSW
-
Heather B. Breen, M.D.
-
Aaron M Carpiaux, MD
-
Kristin Ann Cuff, NP
-
Kyle M Dennison, DPM
-
Christina Friedl, MD
-
Ruth Marie Grams, APNP,
-
Lonna L Grosskopf, CRNA
-
Jacob Kraemer, MD
-
Kirsten Carly Krohn, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040210000666 | WI | Part B Supplier - Clinic/Group Practice | 2567370539 |
Receives reassigned benefits from 1,519 practitioners 15 other NPIs on this enrollment Practice locations: Wauwatosa, WI; Waupun, WI; Watertown, WI; Horicon, WI; Columbus, WI; Beaver Dam, WI |
National Provider Directory
- Part of
- Marshfield Clinic Health System Inc
Locations
705 S University Ave
Ofc
Beaver Dam, WI 53916
705 S University Ave
Ste 360
Beaver Dam, WI 53916
Phone (920) 356-6588
140 Gateway Dr
Waupun, WI 53963
Phone (715) 324-3191
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optician |
156FX1800X | |||
| Clinic/Center | 261Q00000X | Yes |
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
- Marshfield Medical Center - Beaver Dam Professional Services
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 Beaver Dam, WI
- Beaver Dam Community Hospitals Inc
- Beaver Dam Community Hospitals Inc
- Beaver Dam Community Hospitals Inc
- Beaver Dam Community Hospitals Inc
- Beaver Dam Community Hospitals Inc
- Beaver Dam Community Hospitals Inc
- Beaver Dam Community Hospitals Inc
- Beaver Dam Community Hospitals, Inc
- Beaver Dam Dental LLC
- Beaver Dam Emergency Medicine S.C.
All providers in Beaver Dam, WI · 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 Apr 14, 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.