NPIMap

Organization Active NPI

Wausau Podiatry Center LTD

  • Podiatrist
  • Wausau, WI
National Provider Identifier
1093963456
Registry record updated Aug 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
437 Issued in WI
Legal business name
WAUSAU PODIATRY CENTER LTD
Practice address
115 W Bridge St
Wausau, WI 54401-2929
Phone
(715) 842-4288
Fax
(715) 842-2162
NPI assigned
Aug 28, 2008
Last updated
Aug 28, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2008

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

Authorized official

Name
Dr. Anders V Juvonen, DMPNPI 1669403101
Title
President/Podiatrist
Phone
(715) 842-4288

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)CodeLicenseStatePrimary
PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213E00000X 437 WI Primary

Addresses

Primary practice location

115 W Bridge St
Wausau, WI 54401-2929

Mailing address

115 W Bridge St
Wausau, WI 54401-2929
Phone (715) 842-4288

Other identifiers 1

IdentifierTypeStateIssuer
43241200MedicaidWI

National Provider Directory

National Provider Directory

Locations

115 W Bridge St
Wausau, WI 54401
Phone (715) 842-4288

Practitioners & 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.

NPI Registry JSON

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

{
    "created_epoch": "1219881600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1219881600000",
    "number": "1093963456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 W BRIDGE ST",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544012929",
            "telephone_number": "715-842-4288",
            "fax_number": "715-842-2162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 W BRIDGE ST",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544012929",
            "telephone_number": "715-842-4288",
            "fax_number": "715-842-2162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAUSAU PODIATRY CENTER LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-28",
        "last_updated": "2008-08-28",
        "status": "A",
        "authorized_official_last_name": "JUVONEN",
        "authorized_official_first_name": "ANDERS",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "PRESIDENT/PODIATRIST",
        "authorized_official_telephone_number": "715-842-4288",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMP"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "WI",
            "license": "437",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "43241200",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wausau, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.