NPIMap

Organization Active NPI

Beaver Dam Community Hospitals Inc

Doing business as Marshfield Medical Center - Beaver Dam Professional Services

  • Clinic/Center
  • Beaver Dam, WI
National Provider Identifier
1972188555
Registry record updated Apr 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
BEAVER DAM COMMUNITY HOSPITALS INC
Doing business as
Marshfield Medical Center - Beaver Dam Professional Services
Practice address
707 S University Ave
Beaver Dam, WI 53916-3027
Phone
(920) 887-7181
NPI assigned
Mar 15, 2021
Last updated
Apr 14, 2026By 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 Apr 14, 2026

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary
Optician 156FX1800X

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

  • Marshfield Medical Center - Beaver Dam Professional Services Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Cobius Healthcare Solutions

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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

Other NPIs with the same Medicare PAC ID 8

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

Other NPIs on the same Medicare enrollment 14

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

View all 14

National Provider Directory

National Provider Directory
Part of
Marshfield Clinic Health System Inc

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

Locations

705 S University Ave
Ofc
Beaver Dam, WI 53916

705 S University Ave
Ste 360
Beaver Dam, WI 53916
Phone (920) 356-6588

Ownership & related parties

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

Practitioners 1,581

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 1,581

NPI Registry JSON

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

{
    "created_epoch": "1615766400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1776124800000",
    "number": "1972188555",
    "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": "920-887-7181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEAVER DAM COMMUNITY HOSPITALS INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MARSHFIELD CLINIC HEALTH SYSTEM INC",
        "enumeration_date": "2021-03-15",
        "last_updated": "2026-04-14",
        "certification_date": "2026-04-14",
        "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": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1068.1",
            "affiliationName": "Cobius Healthcare Solutions",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "2720 Dundee Rd # 302",
            "city": "Northbrook",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600622609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Marshfield Medical Center - Beaver Dam Professional Services",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Marshfield Medical Center - Beaver Dam Professional Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Beaver Dam, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.