Active NPI
Pine Grove Family Practice Associates LTD
- Family Medicine Physician
- Eau Claire, WI
National Provider Identifier
1053853960
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- Legal business name
- PINE GROVE FAMILY PRACTICE ASSOCIATES LTD
- Practice address
- 3221 Stein Blvd
Eau Claire, WI 54701-4398 - Phone
- (715) 834-2788
- Fax
- (715) 858-3471
- NPI assigned
- Nov 9, 2016
- Last updated
- Nov 9, 2016
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- William Hanson, D.O.
- Title
- Owner
- Phone
- (715) 834-2788
Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | NU | Primary |
Addresses
Primary practice location
3221 Stein Blvd
Eau Claire, WI 54701-4398
Mailing address
3221 Stein Blvd
Eau Claire, WI 54701-4398
Phone (715) 834-2788
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Family Medicine Physician
- Eau Claire, WI
- NPI 1801902069
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1478649600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1478649600000",
"number": "1053853960",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3221 STEIN BLVD",
"city": "EAU CLAIRE",
"state": "WI",
"postal_code": "547014398",
"telephone_number": "715-834-2788",
"fax_number": "715-858-3471"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3221 STEIN BLVD",
"city": "EAU CLAIRE",
"state": "WI",
"postal_code": "547014398",
"telephone_number": "715-834-2788",
"fax_number": "715-858-3471"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PINE GROVE FAMILY PRACTICE ASSOCIATES LTD",
"organizational_subpart": "NO",
"enumeration_date": "2016-11-09",
"last_updated": "2016-11-09",
"status": "A",
"authorized_official_last_name": "HANSON",
"authorized_official_first_name": "WILLIAM",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "715-834-2788",
"authorized_official_credential": "D.O."
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
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 Nov 9, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.