Individual provider Active NPI

Brian L Withers, D.O.

  • Preventive Medicine/Occupational Environmental Medicine Physician
  • La Crosse, WI
National Provider Identifier
1548464902
Registry record updated Jul 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Preventive Medicine/Occupational Environmental Medicine PhysicianTaxonomy code 2083P0500X
License
59876 Issued in WI
Practice address
800 West Ave S
La Crosse, WI 54601
Phone
(608) 785-0940
NPI assigned
Jun 12, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 5101017014 MI
Preventive Medicine/Occupational Environmental Medicine Physician 2083P0500X 59876 WI Primary

Addresses

Primary practice location

800 West Ave S
La Crosse, WI 54601

Mailing address

200 1St St SW
Rochester, MN 55905-0001
Phone (608) 785-0940

Other practice location 1

800 West Ave S
LA Crosse, WI 54601
Phone (608) 785-0940

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address bwithers27647@ehrdirect.mayoclinicmsg.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130808000251 WI Practitioner - Preventive MedicinePractitioner - General Practice 9931349123 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Preventive Medicine
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mayo Clinic Health System-Southwest Wisconsin Region IncGroup PAC ID 0345152443, shared by 9 NPIs, 539 clinicians

Practice addresses (Care Compare)

800 E Blackhawk Ave
Prairie Du Chien, WI 53821-1698
Phone (608) 326-0808

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
59876WIMDPreventive Medicine/Occupational Environmental Medicine Physician
5101017014MIMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mayo Clinic Health System-Northwest Wisconsin Region, Inc. CurrentSince Oct 1, 2024 Accepting new patients
Mayo Clinic Health System-Northwest Wisconsin Region, Inc. CurrentSince Oct 1, 2024 Accepting new patients
Mayo Clinic Health System-Southwest Wisconsin Region, Inc. Current Accepting new patients
Mayo Clinic Health System-Northwest Wisconsin Region, Inc. Current Accepting new patients
Mayo Clinic Health System-Southwest Wisconsin Region, Inc. CurrentSince Aug 4, 2013 Accepting new patients
Mayo Clinic Health System-Southwest Wisconsin Region, Inc. CurrentSince Aug 4, 2013 Accepting new patients
Mayo Clinic Health System-Northwest Wisconsin Region, Inc. Past Accepting new patients

Locations

200 1st St SW
Rochester, MN 55905
Phone (507) 266-4850

1400 Bellinger St
Eau Claire, WI 54703
Phone (715) 838-3311

733 W Clairemont Ave
Eau Claire, WI 54701
Phone (715) 838-3806

232 3rd St N
Ste 100
La Crosse, WI 54601
Phone (608) 392-7400

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

705 E Taylor St
Prairie du Chien, WI 53821
Phone (608) 357-2000

310 W Main St
Sparta, WI 54656
Phone (608) 269-1700

Interoperability endpoints

  • Direct secure messaging: bwithers27647@ehrdirect.mayoclinicmsg.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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1181606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657584000000",
    "number": "1548464902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 1ST ST SW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559050001",
            "telephone_number": "608-785-0940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 WEST AVE S",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "54601",
            "telephone_number": "608-785-0940"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "800 West Ave S",
            "address_purpose": "LOCATION",
            "city": "LA Crosse",
            "state": "WI",
            "postal_code": "54601",
            "country_code": "US",
            "telephone_number": "608-785-0940",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WITHERS",
        "first_name": "BRIAN",
        "middle_name": "L",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-12",
        "last_updated": "2022-07-12",
        "certification_date": "2022-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "MI",
            "license": "5101017014",
            "primary": false
        },
        {
            "code": "2083P0500X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine",
            "state": "WI",
            "license": "59876",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bwithers27647@ehrdirect.mayoclinicmsg.org",
            "affiliation": "N",
            "address_1": "800 West Ave S",
            "city": "LA Crosse",
            "state": "WI",
            "country_code": "US",
            "postal_code": "54601",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in La Crosse, WI

Sources for this page

Verify at the official NPI Registry.