NPIMap

Organization Active NPI

Gundersen Clinic, LTD.

  • Optometrist
  • Whitehall, WI
National Provider Identifier
1215976352
Registry record updated Aug 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
GUNDERSEN CLINIC, LTD.
Practice address
18606 Ervin St
Whitehall, WI 54773-8613
Phone
(608) 782-7300
NPI assigned
Jun 5, 2006
Last updated
Aug 6, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
GUNDERSEN CLINIC, LTD.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 6, 2021

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

Authorized official

Name
Kari B Adank
Title
Cco
Phone
(608) 775-8025

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary
Durable Medical Equipment & Medical Supplies 332B00000X

Addresses

Primary practice location

18606 Ervin St
Whitehall, WI 54773-8613

Mailing address

1836 South Ave
La Crosse, WI 54601-5429
Phone (608) 782-7300

Other names 1

  • GL Vision Center - Whitehall Other name

National Provider Directory

National Provider Directory
Tax ID family
Gundersen Lutheran-Toma53 organizations share this tax ID, including this one
Part of
Gundersen Lutheran-Toma

Organizations with this tax ID in the same state 23

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1149465600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1628208000000",
    "number": "1215976352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1836 SOUTH AVE",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "546015429",
            "telephone_number": "608-782-7300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18606 ERVIN ST",
            "city": "WHITEHALL",
            "state": "WI",
            "postal_code": "547738613",
            "telephone_number": "608-782-7300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GUNDERSEN CLINIC, LTD.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GUNDERSEN CLINIC, LTD.",
        "enumeration_date": "2006-06-05",
        "last_updated": "2021-08-06",
        "certification_date": "2021-08-06",
        "status": "A",
        "authorized_official_last_name": "ADANK",
        "authorized_official_first_name": "KARI",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "CCO",
        "authorized_official_telephone_number": "608-775-8025"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GL Vision Center - Whitehall",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Whitehall, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2021; 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.