Gundersen Clinic, LTD.

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

GUNDERSEN CLINIC, LTD.

Practice address

315 W Oak St
Sparta, WI 54656-2150

Phone

(608) 782-7300

NPI assigned

May 17, 2006

Last updated

Aug 6, 2021By the provider in NPPES

Organization subpart

Yes

Parent organization

GUNDERSEN CLINIC LTDAs reported in NPPES

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

Addresses

Other names 1

• GL Sparta Clinic Other name

Part of

Gundersen Lutheran-Toma

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1628208000000",
    "number": "1467404483",
    "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": "315 W OAK ST",
            "city": "SPARTA",
            "state": "WI",
            "postal_code": "546562150",
            "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": "2006-05-17",
        "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": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GL Sparta Clinic",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• John Douglas Frazee, DDS
• Rebecca Ann Frey, REFLEXOGIST
• Jacob Robert Graboski, DPT
• Gundersen Clinic LTD (Emplify Health Sparta Urgent Care)
• Gundersen Clinic, LTD.
• Gundersen Clinic, LTD. (Gundersen Lutheran Eye Clinic - Sparta)
• Nancy L Haas, MS
• Petra M Hagen, SAC
• Kimberly Hagmann, LPC-IT
• Robert Maurice Halverson Jr., RPH

• Clinic/Center in Sparta, WI
• Providers in Sparta, WI by specialty
• Clinic/Center in Wisconsin

• 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.