SOUTHERN WISCONSIN CENTER
NPI 1043326747
Intermediate Care Facility, Intellectual Disabilities in Union Grove, WI
About Southern Wisconsin Center NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SOUTHERN WISCONSIN CENTER (NPI 1043326747) is a healthcare organization registered as an intermediate care facility, intellectual disabilities in Union Grove, Wisconsin and active in the NPI registry since August 2006. The organization holds a CLIA Waiver certificate valid through December 2, 2027 and lists James E Hutchison, Nursing Home Administrator, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Other Identifiers 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Southern Wisconsin Center is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
19Medicare enrollment records show 19 clinicians reassign Medicare billing to Southern Wisconsin Center, which bills Medicare for the services they deliver. Of these, 1 practice at this address and 2 within 10 miles. They are listed nearest first.
Clinicians by Medicare Specialty 5
Clinicians, nearest first (19)
Madison, WI 53704
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 52D0879904
Southern Wisconsin Center · Union Grove, WIFrequently 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 State Of Wisconsin's NPI number?
The NPI number for State Of Wisconsin is 1043326747. It was assigned to this organization in the NPPES registry on August 22, 2006. The provider is doing business as Southern Wisconsin Center.
Where is State Of Wisconsin located?
State Of Wisconsin is located at 21425 Spring St, Union Grove, WI 53182. The listed phone number is (262) 878-2411.
What is State Of Wisconsin's specialty?
The primary specialty registered for this NPI is Intermediate Care Facility, Intellectual Disabilities with taxonomy code 315P00000X.
Is State Of Wisconsin enrolled in Medicare?
Yes. State Of Wisconsin is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through State Of Wisconsin?
According to the CMS Revalidation Reassignment List (October 2026 release), 19 clinicians in 5 Medicare specialties reassign their Medicare billing to State Of Wisconsin. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Psychiatry (9), Family Practice (4) and Physical Medicine and Rehabilitation (3). Of these, 1 practice at this address and 2 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does State Of Wisconsin hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 52D0879904) is associated with this NPI, valid through December 2, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
When was this NPI record last updated?
The NPPES record for State Of Wisconsin was last updated on February 14, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years 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.
# Southern Wisconsin Center · NPI 1043326747
Intermediate Care Facility, Intellectual Disabilities organization in Union Grove, Wisconsin. Organization record, active in the CMS NPPES registry since August 22, 2006.
## Identity
- **NPI:** 1043326747 (Entity type: Organization)
- **Enumerated:** August 22, 2006
- **Primary specialty:** Intermediate Care Facility, Intellectual Disabilities · taxonomy 315P00000X
- **Legal business name:** State Of Wisconsin
- **Organization subpart:** No
- **Authorized official:** James Hutchison, NURSING HOME ADMINISTRATOR
## Practice location
- **Address:** 21425 SPRING ST, Union Grove, WI 53182-9707
- **Phone:** (262) 878-2411 · **Fax:** (262) 878-2922
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 19 clinicians in 5 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Psychiatry (9), Family Practice (4), Physical Medicine and Rehabilitation (3); 1 practice at this address and 2 within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** February 14, 2008
- **Other identifiers:** Medicaid 21050000 (WI)
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1043326747) · Data from the CMS NPPES public registry.