Active NPI
Kenneth L. Hallwood, CRNA
- Certified Registered Nurse Anesthetist
- Mauston, WI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 3626-33
- Practice address
- 1050 Division St
Mauston, WI 53948-1931 - Phone
- (608) 847-6161
- NPI assigned
- Nov 14, 2005
- Last updated
- Nov 8, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 3626-33 | WI | |
| Certified Registered Nurse Anesthetist | 367500000X | 3626-33 | WI | Primary |
| Certified Registered Nurse Anesthetist | 367500000X | R148073-9 | MN |
Addresses
Primary practice location
1050 Division St
Mauston, WI 53948-1931
Mailing address
1050 Division St
Mauston, WI 53948-1931
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 2003
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
507 S Main St
Viroqua, WI 54665-2059
Phone (608) 637-2101
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 91.7 of 100
- Quality
- 91.14
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 77.5
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R148073-9 | MN | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Divine Savior Healthcare, Inc. | Current | Accepting new patients | |
| Divine Savior Healthcare, Inc. | Current | Accepting new patients | |
| Mile Bluff Medical Center Inc | Current | Accepting new patients | |
| Mile Bluff Medical Center Inc | Current | Accepting new patients | |
| Vernon Memorial Healthcare, Inc. | Current | Accepting new patients | |
| Mile Bluff Medical Center Inc | Current | Accepting new patients | |
| Mile Bluff Medical Center Inc | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
Locations
29980 Network Pl
Chicago, IL 60673
1040 Division St
Mauston, WI 53948
Phone (608) 847-5000
1050 Division St
Mauston, WI 53948
Phone (608) 847-6161
2817 New Pinery Rd
Portage, WI 53901
Phone (608) 745-4598
507 S Main St
Viroqua, WI 54665
Phone (608) 637-2101
28 Commerce St
Wisconsin Dells, WI 53965
Phone (608) 254-5888
Interoperability endpoints
- khallwood881203@direct.emplifyhealth.org
Organizations & group practices 7
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Vernon Health
- Critical Access Hospital
- Viroqua, WI
- NPI 1497750921
-
dba Aspirus Divine Savior Hospital
- General Acute Care Hospital
- Portage, WI
- NPI 1124083894
-
dba Mile Bluff ER/UC Providers
- Emergency Medicine Physician
- Mauston, WI
- NPI 1609912005
-
dba Mile Bluff Hospital CRNA
- Certified Registered Nurse Anesthetist
- Mauston, WI
- NPI 1922145077
Nurse Anesthetist, Certified Registered
-
dba Aspirus Portage Clinic
- Rural Health Clinic/Center
- Portage, WI
- NPI 1386154417
-
dba Mile Bluff Urgent Care
- Urgent Care Clinic/Center
- Mauston, WI
- NPI 1437958683
-
dba Mile Bluff Delton Clinic
- Rural Health Clinic/Center
- Wisconsin Dells, WI
- NPI 1487734380
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Vernon Health
- Critical Access Hospital
- Viroqua, WI
- NPI 1497750921
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1131926400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1573171200000",
"number": "1427039718",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1050 DIVISION ST",
"city": "MAUSTON",
"state": "WI",
"postal_code": "539481931"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1050 DIVISION ST",
"city": "MAUSTON",
"state": "WI",
"postal_code": "539481931",
"telephone_number": "608-847-6161"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HALLWOOD",
"first_name": "KENNETH",
"middle_name": "L.",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-11-14",
"last_updated": "2019-11-08",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "WI",
"license": "3626-33",
"primary": false
},
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "WI",
"license": "3626-33",
"primary": true
},
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "MN",
"license": "R148073-9",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Mauston, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.