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BLACK RIVER MEMORIAL HOSPITAL INC
NPI 1063516078
Hospice Care, Community Based in Black River Falls, WI

Active since September 11, 2006CLIA 52D0040042 · Accreditation
311 COUNTY ROAD A STE 1, BLACK RIVER FALLS, WI 54615(715) 284-5361(715) 284-1390 Get Directions Write a Review

NPPES record last updated: December 16, 2016. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Black River Memorial Hospital Inc NPPES

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

BLACK RIVER MEMORIAL HOSPITAL INC (NPI 1063516078) is a healthcare organization registered as a hospice care, community based in Black River Falls, Wisconsin and active in the NPI registry since September 2006. The organization holds an CLIA Accreditation certificate valid through January 2, 2027 and lists Mary Beth White-jacobs, President & Ceo, as its authorized official.

NPPES Registry Identity

NPI1063516078
Entity TypeOrganization
Primary Taxonomy251G00000X
Legal Business NameBLACK RIVER MEMORIAL HOSPITAL INC
Location Address311 COUNTY ROAD A STE 1Black River Falls, WI 54615-8205
Mailing Address711 W Adams StBlack River Falls, WI 54615 · (715) 284-5361 · Fax (715) 284-1390
Phone(715) 284-5361
Fax(715) 284-1390
Organization SubpartNo
Authorized OfficialMary Beth White-jacobsPresident & Ceo · (715) 284-5361
Enumeration DateSeptember 11, 2006
Last NPPES UpdateDecember 16, 2016
✔ NPI 1063516078 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyHospice Care, Community BasedAgencies
Taxonomy Code251G00000X
License✔ Licensed in WI · 1037
311 COUNTY ROAD A STE 1, Black River Falls, WI 54615
Open in Google Maps ↗

Other Identifiers 2

Medicare OSCAR/certification521570
Medicaid43189700WI

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, 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 Accreditation 52D0040042

Black River Memorial Hospital - Black River Health, Inc · Black River Falls, WI
Active · expires Jan 2, 2027
CLIA Number52D0040042
Laboratory TypeHospital
Certificate Effective DateJanuary 3, 2025
Certificate Expiration DateJanuary 2, 2027
Laboratory DirectorDr. Kathyrn Swartz
Laboratory Phone(715) 284-5361
Laboratory LocationBlack River Memorial Hospital - Black River Health, Inc711 W Adams St, Black River Falls, WI 54615
CLIA data matches this NPI record on: Address Name Phone
This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.

Medical Equipment Supplier Medicare DMEPOS 17

Medicare supplier enrollment and the product categories Black River Memorial Hospital Inc carries, from the Medicare DMEPOS supplier directory.

Black River Memorial Hospital Inc

DMEPOS supplier · Black River Falls, WI
✔

Accepts Medicare assignment

Black River Memorial Hospital Inc agrees to accept the Medicare-approved amount as full payment for covered equipment and supplies. Medicare patients are not billed beyond the standard deductible and coinsurance.

PTAN (Medicare Supplier Number)20662937
Medicare Participant SinceJanuary 1, 1998
Supplier Location711 W Adams StBlack River Falls, WI 54615
Phone(608) 284-5361
Provider TypeOxygen & Equipment
Supplier Specialties
MSC With Respiratory Therapist

Medicare Product Categories

Commodes, Urinals, Bedpans
Raised toilets, Drop-arm commodes, Folding commodes, Plastic urinals, Plastic bedpans, Disposable urinals
Blood Glucose Monitors/Supplies (Non-Mail Order)
Home blood glucose monitors including lancets, reagent strips, and other supplies necessary for the proper functioning of the device
Heat & Cold Applications
Heat therapy, Cold therapy, Heating pads
Hospital Beds (Electric)
Total electric hospital beds, Semi-electric hospital beds
Support Surfaces: Pressure Reducing Beds/Mats/Pads
Group 1 – Alternating pressure pad, Air/Water/Dry pressure pad or pressure mattress. Group 2 - Pressure reducing powered air mattresses, Powered air flotation bed, non-powered pressure reducing mattress Group 3 – Air fluidized bed
Ultraviolet Light Devices and/or Supplies
Hand-held phototherapy devices, UV light therapy panels, Multidirectional light therapy
Product categories are from the Medicare DMEPOS supplier directory. Contact the supplier to confirm current availability of specific items.

Other Providers at the Same Location NPPES

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

BLACK RIVER MEMORIAL HOSPITAL INC
Home Health
311 COUNTY ROAD A STE 1
BLACK RIVER FALLS, WI 54615
Jackson County (715) 284-5361

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 Memorial Hospital Inc's NPI number?

The NPI number for Black River Memorial Hospital Inc is 1063516078. It was assigned to this organization in the NPPES registry on September 11, 2006.

Where is Black River Memorial Hospital Inc located?

Black River Memorial Hospital Inc is located at 311 County Road A Ste 1, Black River Falls, WI 54615. The listed phone number is (715) 284-5361.

What is Black River Memorial Hospital Inc's specialty?

The primary specialty registered for this NPI is Hospice Care, Community Based with taxonomy code 251G00000X.

Does Black River Memorial Hospital Inc accept Medicare assignment for medical equipment?

Yes. As a Medicare medical equipment supplier, Black River Memorial Hospital Inc accepts Medicare assignment: the supplier accepts the Medicare-approved amount as payment in full for covered equipment and supplies.

Does Black River Memorial Hospital Inc hold a CLIA laboratory certificate?

Yes. A Certificate of Accreditation (number 52D0040042) is associated with this NPI, valid through January 2, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Black River Memorial Hospital Inc accept?

Health plans from Anthem Blue Cross and Blue Shield and HealthPartners list Black River Memorial Hospital 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 Memorial Hospital Inc was last updated on December 16, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.