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BLACK RIVER HEALTH INC
NPI 1003914011
Medicare Defined Swing Bed Unit in Black River Falls, WI

Active since September 21, 2006CLIA 52D2264019 · Waiver
711 W ADAMS ST, BLACK RIVER FALLS, WI 54615(715) 284-5361(715) 284-1390 Get Directions Write a Review

NPPES record last updated: April 4, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Apr 4, 2025, Jan 6, 2025, Jan 1, 2025 and 1 more (4 updates tracked since 2023).

About Black River Health Inc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BLACK RIVER HEALTH INC (NPI 1003914011) is a healthcare organization registered as a medicare defined swing bed unit in Black River Falls, Wisconsin and active in the NPI registry since September 2006. The organization holds a CLIA Waiver certificate valid through July 7, 2028 and lists Catherine M Bukowski, Cfo, as its authorized official.

NPPES Registry Identity

NPI1003914011
Entity TypeOrganization
Primary Taxonomy275N00000X
Legal Business NameBLACK RIVER HEALTH INC
Location Address711 W ADAMS STBlack River Falls, WI 54615-9108
Mailing Address711 W Adams StBlack River Falls, WI 54615-9108 · (715) 284-5361 · Fax (715) 284-1390
Phone(715) 284-5361
Fax(715) 284-1390
Organization SubpartNo
Authorized OfficialCatherine M BukowskiCfo · (715) 284-3661
Enumeration DateSeptember 21, 2006
Last NPPES UpdateApril 4, 20254 updates tracked since enumeration
NPPES CertifiedApril 4, 2025
✔ NPI 1003914011 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyMedicare Defined Swing Bed UnitHospital Units
Taxonomy Code275N00000X
License✔ Licensed in WI · 1037
Definition
A unit of a hospital that has a Medicare provider agreement and has been granted approval from HCFA to provide post-hospital extended care services and be reimbursed as a swing-bed unit.
711 W ADAMS ST, Black River Falls, WI 54615
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include HealthPartners.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 52D2264019

Black River Healthcare Clinic - Black River Health, Inc · Black River Falls, WI
Active · expires Jul 7, 2028
CLIA Number52D2264019
Laboratory TypeRural Health Clinic
Certificate Effective DateJuly 8, 2026
Certificate Expiration DateJuly 7, 2028
Laboratory DirectorAngela J. Marciulionis
Laboratory Phone(715) 284-3223
Laboratory LocationBlack River Healthcare Clinic - Black River Health, Inc711 W Adams St, Black River Falls, WI 54615
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

REBECCA LYNN WINDSOR PTA
Physical Therapy Assistant
711 W ADAMS ST
BLACK RIVER FALLS, WI 54615
Jackson County (715) 284-1330
GUNDERSEN LUTHERAN MEDICAL CENTER INC
Clinic/Center (End-Stage Renal Disease (ESRD) Treatment)
711 W ADAMS ST
BLACK RIVER FALLS, WI 54615
Jackson County (608) 782-7300
BLACK RIVER HEALTH INC
Non-Pharmacy Dispensing Site
711 W ADAMS ST
BLACK RIVER FALLS, WI 54615
Jackson County (952) 653-2525
MR. JARED RICHARD SHERMAN PA-C
Physician Assistant
711 W ADAMS ST
BLACK RIVER FALLS, WI 54615
Jackson County (907) 202-0718
NICHOLAS RAYMOND THOMPSON DPM
Podiatrist (Foot & Ankle Surgery)
711 W ADAMS ST
BLACK RIVER FALLS, WI 54615
Jackson County (715) 284-1354
MR. NATHAN A SWAN DPT
Physical Therapist
711 W ADAMS ST
BLACK RIVER FALLS, WI 54615
Jackson County (715) 284-5361
BRENNA ANN PETERS DNP
Nurse Practitioner (Family)
711 W ADAMS ST
BLACK RIVER FALLS, WI 54615
Jackson County (715) 284-5361
MS. DAWN CYNTHIA JACOBSON MA, ATC, NASM-CES
Specialist/Technologist (Athletic Trainer)
711 W ADAMS ST
BLACK RIVER FALLS, WI 54615
Jackson County (715) 284-1338

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Black River Health Inc's NPI number?

The NPI number for Black River Health Inc is 1003914011. It was assigned to this organization in the NPPES registry on September 21, 2006.

Where is Black River Health Inc located?

Black River Health Inc is located at 711 W Adams St, Black River Falls, WI 54615. The listed phone number is (715) 284-5361.

What is Black River Health Inc's specialty?

The primary specialty registered for this NPI is Medicare Defined Swing Bed Unit with taxonomy code 275N00000X.

Does Black River Health Inc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 52D2264019) is associated with this NPI, valid through July 7, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Black River Health Inc accept?

Health plans from HealthPartners list Black River Health Inc as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Black River Health Inc was last updated on April 4, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.