Aspirus Ironwood Hospital & Clinics, Inc.
Organization Active NPI Family Medicine Physician · Ironwood, MI
NPI 1992704753 · NPPES record last updated Jun 7, 2024
Key facts
- NPI
- 1992704753
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- Legal business name
- ASPIRUS IRONWOOD HOSPITAL & CLINICS, INC.
- Practice address
- N10565 Grandview LN
Ironwood, MI 49938-9622 - Phone
- (906) 932-1500
- Fax
- (906) 932-5630
- NPI assigned
- Jul 14, 2005
- Organization subpart
- No
Authorized official
- Name
- Jerry M Yang
- Title
- SVP & Chief Financial Officer
- Phone
- (715) 847-2526
Owners & managing parties with NPI records 5
-
Kristen Meske, AGPCNP
-
John Pietila, M.D.
-
Kirk Robert Schott, O.D.
-
Daniel John Lukes, D.O.
Other NPIs on the same Medicare enrollment 9
Other NPIs with the same Medicare PAC ID 4
Corporate family (same tax ID) 3
Member of 1
Related certifications (CCN) 8
Facilities with the same owner 79
Practitioners 358
-
Marites Q Ansay, M.D.
-
Christina M Barber, CRNA
-
Jason F Bombard, D.O.
-
Tatyana G Bombard, D.O
-
Kristen J Bracklein, D.O.
-
Enrico Braucher, MD
-
Meredith Caudill, FNP-C
-
Charity Caverly, FNP-BC
-
Robert M Covington, D.O.
-
Ashley E Croasdell, FNP
-
Tasha N Hudson, DNP, APRN, AGCNS-BC
-
Ashley Koski, FNP-C
-
Klaus Peter Kutschke, M.D.
-
Sharon E Long, FNP
-
Tina M Marshall, NP
-
Nathan Dale McParlan, M.D.
-
Michael David McPherson, PT, DPT
-
Erin Marie Meyer, DO
-
Leanna Miller, FNP
Affiliated clinicians 165
-
Christina M Barber, CRNA
-
Jason F Bombard, D.O.
-
Tatyana G Bombard, D.O
-
Kristen J Bracklein, D.O.
-
Enrico Braucher, MD
-
Kasey J. Burke, FNP-C
-
Emily E Busha, PA-C
-
Meredith Caudill, FNP-C
-
Charity Caverly, FNP-BC
-
Robert M Covington, D.O.
-
Helen Domitrovich, APRN, DNP, FNP-C
-
Allison Harr, APRN CNM
-
Tasha N Hudson, DNP, APRN, AGCNS-BC
-
Eve J. Komosa, PA-C
-
Ashley Koski, FNP-C
-
Klaus Peter Kutschke, M.D.
Medicare Care Compare: Hospital
- Listed as
- Aspirus Ironwood Hospital
- Type
- Critical Access Hospitals
- Ownership
- Voluntary non-profit - Private
- Medicare certification status
- Active
- Emergency services
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (4 enrollments) in MI, WI
Hospital certification: CCN 231333
- Legal name
- ASPIRUS IRONWOOD HOSPITAL & CLINICS INC
- Doing business as
- ASPIRUS IRONWOOD HOSPITAL
- Certification status
- Active
- Provider type (POS)
- Hospital – Critical access hospital
- Participating since
- Sep 1, 2005
- Last certification
- Oct 16, 2012
- Beds
- 25
- Ownership / control type
- Private (not for profit)
- Organization structure
- Corporation · Non-profit
- Enrollment address
- N10561 Grandview LN
Ironwood, MI 49938-9622
Rural health clinic certification: CCN 238661
- Legal name
- ASPIRUS IRONWOOD HOSPITAL & CLINICS INC
- Doing business as
- ASPIRUS IRONWOOD CLINIC
- Certification status
- Active
- Provider type (POS)
- Rural health clinic
- Participating since
- Apr 12, 2013
- Last certification
- Apr 12, 2013
- Ownership / control type
- 2B
- Organization structure
- Corporation · Non-profit
- Enrollment address
- N10565 Grandview LN
Ironwood, MI 49938-9622 - Related CCNs
- 231333
All disclosed owners & managing parties 21
| Name | Role | Since | Share |
|---|---|---|---|
| Jennifer Redman-Schell |
Corporate Director |
Oct 1, 2019 | |
| Jerry M Yang |
Corporate Director |
Feb 26, 2024 | |
| W-2 Managing Employee |
Feb 26, 2024 | ||
| Operational/Managerial Control |
Feb 26, 2024 | ||
| Kristen Meske |
Corporate Director |
Oct 1, 2020 | |
| Paula Chermside |
W-2 Managing Employee |
Jan 1, 2013 | |
| Operational/Managerial Control |
Jan 1, 2013 | ||
| Aspirus, Inc |
5% Or Greater Direct Ownership Interest | Jul 1, 2015 | 100% |
| Operational/Managerial Control | Jul 1, 2015 | 100% | |
| Robin L Meneguzzo |
Corporate Director |
Oct 1, 2022 | |
| Daniel J Lukes |
Corporate Director |
Oct 1, 2019 | |
| John Matonich |
Corporate Director |
Oct 1, 2022 | |
| Katie Clark |
Corporate Director |
Oct 21, 2019 | |
| James Richardson |
Corporate Director |
Oct 1, 2021 | |
| Patrick Tincher |
Corporate Director |
Oct 1, 2020 | |
| Richard Koubek |
Corporate Director |
Oct 1, 2020 | |
| Jonathan N Brueggeman |
Corporate Director |
Oct 21, 2019 | |
| Charly Loper |
Corporate Director |
Oct 1, 2023 | |
| Lori Peck |
Corporate Director |
Sep 30, 2015 | |
| W-2 Managing Employee |
Sep 30, 2015 | ||
| Operational/Managerial Control |
Sep 30, 2015 | ||
| W-2 Managing Employee |
Sep 30, 2015 | ||
| Operational/Managerial Control |
Sep 30, 2015 | ||
| Hannah Goodman |
Corporate Director |
Oct 1, 2023 | |
| Kirk R Schott |
Corporate Director |
Oct 21, 2019 | |
| Tyler Hack |
Corporate Director |
Feb 26, 2024 | |
| W-2 Managing Employee |
Feb 26, 2024 | ||
| Operational/Managerial Control |
Feb 26, 2024 | ||
| John Pietila |
Corporate Director |
Oct 1, 2022 | |
| Christine Harff |
Corporate Director |
Jun 24, 2019 | |
| Matthew F Heywood |
Corporate Officer |
Jul 31, 2013 | |
| W-2 Managing Employee | Jul 31, 2013 | ||
| Operational/Managerial Control |
Jul 31, 2013 | ||
| Corporate Director | Jul 31, 2013 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20031121000096 | MI | Part B Supplier - Clinic/Group Practice | 9032013198 |
Receives reassigned benefits from 288 practitioners 7 other NPIs on this enrollment Practice locations: Ironwood, MI; Wakefield, MI; Ontonagon, MI; Laurium, MI; Lanse, MI; Iron River, MI; Crystal Falls, MI |
| O20040206000462 | WI | Part B Supplier - Clinic/Group Practice | 9032013198 |
Receives reassigned benefits from 3 practitioners 3 other NPIs on this enrollment Practice locations: Hurley, WI |
| O20070223000676 | MI | Part a Provider - Critical Access Hospital | 6406756691 |
Receives reassigned benefits from 248 practitioners 5 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Hurley, WI; Iron River, MI; Ironwood, MI |
| O20121026000114 | MI | Part a Provider - Rural Health Clinic | 9032013198 |
1 other NPI on this enrollment Practice locations: Ironwood, MI |
National Provider Directory
- Tax ID family
- Aspirus Grand View
Locations
E6112 E Bluffview Rd
Ste 101
Ironwood, MI 49938
Phone (906) 932-2231
405 Sunday Lake St
Wakefield, MI 49968
Phone (906) 229-5650
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | Yes | ||
| Geriatric Medicine (Family Medicine) Physician |
207QG0300X | 383005582 | MI | |
| Internal Medicine Physician |
207R00000X | |||
| Obstetrics & Gynecology Physician |
207V00000X | |||
| Podiatrist |
213E00000X | |||
| Rural Health Clinic/Center | 261QR1300X | |||
| Physician Assistant |
363A00000X | |||
| Primary Care Nurse Practitioner |
363LP2300X |
Addresses
Primary practice location
N10565 Grandview LN
Ironwood, MI 49938-9622
Mailing address
N10565 Grandview LN
Ironwood, MI 49938-9622
Phone (906) 932-1500
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 700B710030 | Other | MI | BCBS |
| 02W43GR | Other | MN | BCBS |
| 32849900 | Medicaid | WI | |
| 383005582010 | Other | WI | BCBS |
Other names
- Aspirus Grand View
Other providers in Ironwood, MI
- Aspirus Ironwood Hospital & Clinics, Inc.
- Aspirus Ironwood Hospital & Clinics, Inc.
- Aspirus Ironwood Hospital & Clinics, Inc.
- Aspirus Ironwood Hospital & Clinics, Inc.
- Aspirus Ironwood Hospital & Clinics, Inc.
- Aspirus Medical Group, Inc.
- Aspirus Specialists, Inc
- Aspirus Wausau Hospital, Inc.
- Atrium Ironwood LLC
- Franz Esko Aukee
All providers in Ironwood, MI · Family Medicine Physician in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 7, 2024. 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.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.