Emma J. Banwart, FNP
Individual provider Active NPI Nurse Practitioner · La Crosse, WI
NPI 1306036009 · NPPES record last updated Jul 25, 2022
Key facts
- NPI
- 1306036009
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- 164299 (WI)
- Practice address
- 800 West Avenue South
La Crosse, WI 54601 - Phone
- (608) 782-9760
- NPI assigned
- Jul 28, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 10
Hospital & facility affiliations 3
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2008
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Mayo Clinic Health System-Southwest Wisconsin Region Inc
Practice addresses (Care Compare)
1303 S Main St
Holmen, WI 54636-8927
Phone (608) 526-3351
191 Theater Rd
Onalaska, WI 54650-8679
Phone (608) 392-5000
310 W Main St
Sparta, WI 54656-2170
Phone (608) 269-1770
700 W Ave S
La Crosse, WI 54601-4783
Phone (608) 785-0940
800 E Blackhawk Ave
Prairie Du Chien, WI 53821-1698
Phone (608) 326-0808
800 W Ave S
La Crosse, WI 54601-8806
Phone (608) 785-0940
Hospital & facility affiliations
- Mayo Clinic Health System-Franciscan Medical Center Inc
- Mayo Clinic HLTH Systm Franciscan Hlthcare Sparta
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20081008000289 | WI | Practitioner - Nurse Practitioner | 5698843381 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 200340596RN | OR | MD | General Practice Registered Nurse |
| 164299 | WI | MD | Nurse Practitioner |
| 3490 | WI | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mayo Clinic Health System-Southwest Wisconsin Region, Inc. | Current |
Accepting new patients | |
| Mayo Clinic Health System-Southwest Wisconsin Region, Inc. | Current | Accepting new patients | |
| Mayo Clinic Health System-Southwest Wisconsin Region, Inc. | Current |
Accepting new patients |
Locations
200 1st St SW
Rochester, MN 55905
Phone (507) 266-4850
800 West Ave S
La Crosse, WI 54601
Phone (608) 372-5951
800 E Blackhawk Ave
Prairie du Chien, WI 53821
Phone (608) 326-0808
310 W Main St
Sparta, WI 54656
Phone (608) 269-1700
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Registered Nurse | 163WG0000X | 200340596RN | OR | |
| Family Nurse Practitioner | 363LF0000X | 3490 | WI | |
| Nurse Practitioner | 363L00000X | 164299 | WI | Yes |
Addresses
Primary practice location
800 West Avenue South
La Crosse, WI 54601
Mailing address
200 1St St SW
Rochester, MN 55905-0001
Phone (608) 785-0940
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | ebanwart28337@ehrdirect.mayoclinicmsg.org |
Other providers in La Crosse, WI
- Vijay Bandhakavi
- Maseray M Bangura
- Paula A Bank
- Marlene A Bannen
- Amy L Bantle
- Connie Bao
- Marisa A Baorto
- Nicole L Barbee
- Linda M Barbour
- Ryan Barfknecht
All providers in La Crosse, WI · Nurse Practitioner in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 25, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.