NPIMap

Organization Active NPI

Oakleaf Clinics SC

  • Obstetrics & Gynecology Physician
  • Eau Claire, WI
National Provider Identifier
1023400819
Registry record updated Jan 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
OAKLEAF CLINICS SC
Doing business as
OakLeaf Clinics, SC - OB-GYN Clinic of Eau Claire
Practice address
1110 Oak Ridge Dr
Eau Claire, WI 54701-6133
Phone
(715) 834-9998
Fax
(715) 834-9833
NPI assigned
Mar 3, 2015
Organization subpart
Yes
Parent organization
OAKLEAF CLINICS, SCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 28, 2021

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

Authorized official

Name
Dr. Chris R Longbella, MD
Title
Director
Phone
(715) 836-9242

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207V00000X Primary
Gynecology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207VG0400X
Obstetrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207VX0000X

Addresses

Primary practice location

1110 Oak Ridge Dr
Eau Claire, WI 54701-6133

Mailing address

719 W Hamilton Ave Ste B
Eau Claire, WI 54701-6970
Phone (715) 552-9784

Other names 1

  • OakLeaf Clinics, SC - OB-GYN Clinic of Eau Claire Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110602000195 WI Part B Supplier - Clinic/Group Practice 4486831328 Receives reassigned benefits from 120 practitioners
15 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Rice Lake, WI; Menomonie, WI; Ladysmith, WI; Eau Claire, WI; Cornell, WI; Chippewa Falls, WI; Altoona, WI

Other NPIs on the same Medicare enrollment 15

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

View all 15

National Provider Directory

National Provider Directory
Part of
Oakleaf Clinics SC

Locations

1110 7th Ave
Cumberland, WI 54829
Phone (715) 822-2741

NPI Registry JSON

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

{
    "created_epoch": "1425340800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611792000000",
    "number": "1023400819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "719 W HAMILTON AVE STE B",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "547016970",
            "telephone_number": "715-552-9784",
            "fax_number": "715-835-6370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110 OAK RIDGE DR",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "547016133",
            "telephone_number": "715-834-9998",
            "fax_number": "715-834-9833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OAKLEAF CLINICS SC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "OAKLEAF CLINICS, SC",
        "enumeration_date": "2015-03-03",
        "last_updated": "2021-01-28",
        "certification_date": "2021-01-28",
        "status": "A",
        "authorized_official_last_name": "LONGBELLA",
        "authorized_official_first_name": "CHRIS",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "715-836-9242",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207VG0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207VX0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology, Obstetrics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "OakLeaf Clinics, SC - OB-GYN Clinic of Eau Claire",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "OakLeaf Clinics, SC - OB-GYN Clinic of Eau Claire",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Eau Claire, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.