Individual provider Active NPI

Lawrence Wesley Waite, D.O.

  • Family Medicine Physician
  • Onalaska, WI
National Provider Identifier
1083663967
Registry record updated May 18, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
40617 Issued in MN
Practice address
2110 Evenson Dr
Onalaska, WI 54650-8772
Phone
(608) 397-6678
Fax
(608) 781-5576
NPI assigned
May 9, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 18, 2010

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

Specialties & licenses 12

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Neuromusculoskeletal Medicine) Physician 204C00000X 40617 MN
Sports Medicine (Neuromusculoskeletal Medicine) Physician 204C00000X 03005 IA
Sports Medicine (Neuromusculoskeletal Medicine) Physician 204C00000X 036-063775 IL
Neuromusculoskeletal Medicine & OMM Physician 204D00000X 37512-04 WI
Emergency Medical Services (Emergency Medicine) Physician 207PE0004X 036-063775 IL
Emergency Medical Services (Emergency Medicine) Physician 207PE0004X 03005 IA
Emergency Medical Services (Emergency Medicine) Physician 207PE0004X 40617 MN
Emergency Medical Services (Emergency Medicine) Physician 207PE0004X 37512-021 WI
Family Medicine Physician 207Q00000X 37512-021 WI
Family Medicine Physician 207Q00000X 40617 MN Primary
Family Medicine Physician 207Q00000X 03005 IA
Family Medicine Physician 207Q00000X 036-063775 IL

Addresses

Primary practice location

2110 Evenson Dr
Onalaska, WI 54650-8772

Mailing address

2110 Evenson Dr
Onalaska, WI 54650-8772
Phone (608) 397-6678

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, MN2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20040313000100 WI Practitioner - Family PracticePractitioner - Emergency Medicine 6305735713 Reassigns benefits to 3 organizations
I20041210000008 MN Practitioner - Family PracticePractitioner - Emergency Medicine 6305735713 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Des Moines University of Osteopathic Medicine and Health Sciences, 1975
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Winona Health ServicesGroup PAC ID 8527977420, 160 clinicians

Practice addresses (Care Compare)

855 Mankato Ave
Winona, MN 55987-4868
Phone (507) 454-3650

Hospital & facility affiliations

  • Winona Health Services Hospital, Winona, MN, CCN 240044

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
37512-04WIMDNeuromusculoskeletal Medicine & OMM Physician
03005IAMDFamily Medicine Physician
036-063775ILMDFamily Medicine Physician
40617MNMDFamily Medicine Physician
37512-021WIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tomah Memorial Hospital Inc Current Accepting new patients
Tomah Memorial Hospital Inc CurrentSince Jan 1, 2015 Accepting new patients
Spooner Health System, Inc. Current Accepting new patients
Tomah Memorial Hospital Inc CurrentSince Jan 1, 2015 Accepting new patients
Winona Health Services CurrentSince Oct 15, 2012 Accepting new patients
Winona Health Services CurrentSince Oct 15, 2012 Accepting new patients
Gundersen Clinic LTD Past Accepting new patients

Locations

712 S Cascade St
Fergus Falls, MN 56537

500 W Grant St
Lake City, MN 55041
Phone (651) 345-3321

855 Mankato Ave
Winona, MN 55987
Phone (507) 454-3680

1280 Chandler Dr
Spooner, WI 54801
Phone (715) 635-2111

321 Butts Ave
Tomah, WI 54660
Phone (608) 372-2181

501 Gopher Dr
Tomah, WI 54660
Phone (608) 371-2181

507 S Main St
Viroqua, WI 54665
Phone (608) 637-2101

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1147132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1274140800000",
    "number": "1083663967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2110 EVENSON DR",
            "city": "ONALASKA",
            "state": "WI",
            "postal_code": "546508772",
            "telephone_number": "608-397-6678",
            "fax_number": "608-781-5576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2110 EVENSON DR",
            "city": "ONALASKA",
            "state": "WI",
            "postal_code": "546508772",
            "telephone_number": "608-397-6678",
            "fax_number": "608-781-5576"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAITE",
        "first_name": "LAWRENCE",
        "middle_name": "WESLEY",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-09",
        "last_updated": "2010-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204C00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine, Sports Medicine",
            "state": "MN",
            "license": "40617",
            "primary": false
        },
        {
            "code": "204C00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine, Sports Medicine",
            "state": "IA",
            "license": "03005",
            "primary": false
        },
        {
            "code": "204C00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine, Sports Medicine",
            "state": "IL",
            "license": "036-063775",
            "primary": false
        },
        {
            "code": "204D00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine & OMM",
            "state": "WI",
            "license": "37512-04",
            "primary": false
        },
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "IL",
            "license": "036-063775",
            "primary": false
        },
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "IA",
            "license": "03005",
            "primary": false
        },
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "MN",
            "license": "40617",
            "primary": false
        },
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "WI",
            "license": "37512-021",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "37512-021",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "40617",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "03005",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036-063775",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Onalaska, WI

Sources for this page

Verify at the official NPI Registry.