Lane A Woldum, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

37299 Issued in WI

Practice address

611 1St Ave
Chippewa Falls, WI 54729-1242

Phone

(715) 838-5222

NPI assigned

Jun 17, 2006

Last updated

Jul 15, 2009By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Cigna Health Care of Arizona Inc.

  dba CMG Clyde Wright Urgent Care, CMG Clyde Wright AHC, Phoenix Central UC

  • Urgent Care Clinic/Center
  • Phoenix, AZ
  • NPI 1245338235
  NPD
• Cigna Health Care of Arizona Inc.

  dba EVERNORTH Care Group South Mountain Health Center

  • Clinic/Center
  • Phoenix, AZ
  • NPI 1508937236
  NPD
• Cigna Health Care of Arizona Inc.

  dba Clyde Wright Center, CMG Phx Central MultiSpec Cntr

  • Multi-Specialty Clinic/Center
  • Phoenix, AZ
  • NPI 1942371679
  NPD
• Cigna Healthcare of Arizona, Inc.

  dba EVERNORTH Care Group

  • Multi-Specialty Clinic/Center
  • Scottsdale, AZ
  • NPI 1073626404
  NPD
• Frances Mahon Deaconess Hospital

  • Critical Access Hospital
  • Glasgow, MT
  • NPI 1689685323
  NPD (past)

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

{
    "created_epoch": "1150502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1247616000000",
    "number": "1588609481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1510",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "547021510",
            "telephone_number": "715-838-5222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 1ST AVE",
            "city": "CHIPPEWA FALLS",
            "state": "WI",
            "postal_code": "547291242",
            "telephone_number": "715-838-5222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLDUM",
        "first_name": "LANE",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-17",
        "last_updated": "2009-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "37299",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32178300",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Daniel J Winn, D.D.S.
• Karen Wirtanen
• Barbara Mary Wise, P.T.
• Wissota Chiropractic
• Angela Rose Woelpern, PMHNP
• Renee Marie Wolfe, LPN
• Wolftever Healthcare, LLC (Rutledge Home)
• Timothy John Wolter, MD
• Brendon Patrick Yaroch, OD
• Susan Yetter

• Family Medicine Physician in Chippewa Falls, WI
• Providers in Chippewa Falls, WI by specialty
• Family Medicine Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.