Individual provider Active NPI

Gordon J Grieshaber, MD

  • Family Medicine Physician
  • Mineral Point, WI
National Provider Identifier
1174518039
Registry record updated Feb 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
34127 Issued in WI
Practice address
104 High St
Mineral Point, WI 53565-1289
Phone
(608) 987-2346
Fax
(608) 987-2490
NPI assigned
Sep 16, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 34127 WI Primary

Addresses

Primary practice location

104 High St
Mineral Point, WI 53565-1289

Mailing address

104 High St
Mineral Point, WI 53565-1289
Phone (608) 987-2346

Other identifiers 1

IdentifierTypeStateIssuer
31918300MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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 1

Enrollment IDStateProvider typePAC IDDetails
I20100816001011 WI Practitioner - Family Practice 6901873512 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
34127WIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Upland Hills Health Inc Current Accepting new patients
Upland Hills Health Inc Current Accepting new patients
Upland Hills Health, Inc. CurrentSince Dec 1, 2025 Accepting new patients
Upland Hills Health, Inc. Family Medicine CurrentSince Oct 1, 2018 Accepting new patients
Upland Hills Health, Inc CurrentSince Oct 1, 2018 Accepting new patients
Upland Hills Health, Inc. Family Medicine Past Accepting new patients
Upland Hills Health, Inc. Family Medicine Past Accepting new patients
Upland Hills Health, Inc, Family Medicine Past Accepting new patients
Upland Hills Health, Inc Family Medicine Past Accepting new patients
Upland Hills Health, Inc. Family Medicine Past Accepting new patients

Locations

103 Quail Ridge Dr
Barneveld, WI 53507
Phone (608) 924-1088

1204 Joseph St
Dodgeville, WI 53533
Phone (608) 574-5044

800 Compassion Way
Dodgeville, WI 53533
Phone (608) 930-7200

1050 Branger Dr
Ste 1
Mineral Point, WI 53565

1883 Springdale St
Mount Horeb, WI 53572
Phone (608) 437-8040

Interoperability endpoints

  • Direct secure messaging: gordon.grieshaber@mpmc.directbygreenway.com
  • Direct secure messaging: ggrieshaber260108@direct-ehr-ssmhc.com

Organizations & group practices 11

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.

NPI Registry JSON

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

{
    "created_epoch": "1126828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1359676800000",
    "number": "1174518039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 HIGH ST",
            "city": "MINERAL POINT",
            "state": "WI",
            "postal_code": "535651289",
            "telephone_number": "608-987-2346",
            "fax_number": "608-987-2490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 HIGH ST",
            "city": "MINERAL POINT",
            "state": "WI",
            "postal_code": "535651289",
            "telephone_number": "608-987-2346",
            "fax_number": "608-987-2490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIESHABER",
        "first_name": "GORDON",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-16",
        "last_updated": "2013-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "34127",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "31918300",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mineral Point, WI

Sources for this page

Verify at the official NPI Registry.