Wolverine Anesthesia, LLC

Primary specialty

Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X

Legal business name

WOLVERINE ANESTHESIA, LLC

Practice address

1420 London Rd
Suite 100
Duluth, MN 55805-2433

Phone

(218) 728-8548

NPI assigned

May 19, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Hal Heyer, MDNPI 1487608675

Title

President

Phone

(218) 728-8548

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN, WI2 enrollments

Enrollment records 2

Locations

Practitioners 4

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.

• Neil J Anderson, CRNA

  • Certified Registered Nurse Anesthetist
  • Duluth, MN
  • NPI 1912958034

  WI

  Medicare reassignment Care Compare group NPD
• Christopher Michael Davies, M.D.

  • Pain Medicine (Anesthesiology) Physician
  • Duluth, MN
  • NPI 1194165050

  WI

  Medicare reassignment Care Compare group NPD
• Hal B Heyer, MD

  • Pain Medicine (Anesthesiology) Physician
  • Duluth, MN
  • NPI 1487608675
  Medicare reassignment NPD Authorized official
• Laura Glaus, PA-C

  • Physician Assistant
  • Duluth, MN
  • NPI 1154751998

  WI

  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1285688788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14700 28TH AVE N",
            "address_2": "SUITE 20",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554474835",
            "telephone_number": "763-559-3779",
            "fax_number": "763-450-3986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1420 LONDON RD",
            "address_2": "SUITE 100",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558052433",
            "telephone_number": "218-728-8548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOLVERINE ANESTHESIA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HEYER",
        "authorized_official_first_name": "HAL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "218-728-8548",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sabrina M Wolfe
• John Wolff, MA, LMFT
• Madelyn Wolff
• Scott E Wolff, MD
• Richard John Wolleat, LICSW
• Renee M Wolvert
• Michael Marc Wolz, MBCHB
• John E Wood, M.D.
• Caroline A Woods, PAC MS
• Carolyn Woods, LICSW

• Pain Medicine (Anesthesiology) Physician in Duluth, MN
• Providers in Duluth, MN by specialty
• Pain Medicine (Anesthesiology) Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.