NPIMap

Organization Active NPI

Gundersen Lutheran Medical Center Inc

Doing business as Emplify Health Viroqua Renal Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Viroqua, WI
National Provider Identifier
1003159195
Registry record updated Aug 31, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
Legal business name
GUNDERSEN LUTHERAN MEDICAL CENTER INC
Doing business as
Emplify Health Viroqua Renal Dialysis
Practice address
407 S Main St Ste 300
Viroqua, WI 54665-4001
Phone
(608) 782-7300
NPI assigned
Mar 27, 2013
Last updated
Aug 31, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
GUNDERSEN LUTHERAN MEDICAL CENTER INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 31, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Debra L Van Pay
Title
Director, Reimbursement
Phone
(920) 436-8628

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X NU Primary

Addresses

Primary practice location

407 S Main St Ste 300
Viroqua, WI 54665-4001

Mailing address

1910 South Ave
La Crosse, WI 54601-5467
Phone (608) 782-7300

Other identifiers 1

IdentifierTypeStateIssuer
100042703MedicaidWI

Other names 2

  • Emplify Health Viroqua Renal Dialysis Doing business as
  • GLMC VIROQUA RENAL DIALYSIS Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040112000075 WI Part A Provider - End-Stage Renal Disease Facility (ESRD) 2163331414 1 other NPI on this enrollment
Practice locations: Viroqua, WI

Other NPIs with the same Medicare PAC ID 15

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

View all 15

Other NPIs on the same Medicare enrollment 1

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

Care Compare: Dialysis facility

Medicare Care Compare
Listed as
Gundersen Lutheran Renal Dialysis - ViroquaCCN 523517
Overall star rating
4.0 of 5
Ownership
Non-profit
Certified
Sep 18, 1998
Medicare certification status
ActiveFrom the Provider of Services file
Chain
Gundersen Lutheran
Dialysis stations
12

Name & address match This facility record has no NPI; it was connected to this NPI by matching name and address.

National Provider Directory

National Provider Directory
Tax ID family
Gundersen Lutheran Medical Center27 organizations share this tax ID, including this one
Part of
Gundersen Lutheran Medical Center

Other organizations with this tax ID 26

Organizations that report the same tax identification number in the National Provider Directory.

View all 26

Locations

407 S Main St
Ste 300
Viroqua, WI 54665
Phone (608) 637-4376

Practitioners & affiliated clinicians

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1364342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1788134400000",
    "number": "1003159195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1910 SOUTH AVE",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "546015467",
            "telephone_number": "608-782-7300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "407 S MAIN ST STE 300",
            "city": "VIROQUA",
            "state": "WI",
            "postal_code": "546654001",
            "telephone_number": "608-782-7300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GUNDERSEN LUTHERAN MEDICAL CENTER INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GUNDERSEN LUTHERAN MEDICAL CENTER INC",
        "enumeration_date": "2013-03-27",
        "last_updated": "2026-08-31",
        "certification_date": "2026-08-31",
        "status": "A",
        "authorized_official_last_name": "VAN PAY",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "DIRECTOR, REIMBURSEMENT",
        "authorized_official_telephone_number": "920-436-8628"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100042703",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Emplify Health Viroqua Renal Dialysis",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "GLMC VIROQUA RENAL DIALYSIS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Viroqua, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.