NPIMap

Individual provider Active NPI

Christine Joanne Waller, M.D.

  • Surgical Critical Care Physician
  • La Crosse, WI
National Provider Identifier
1588826705
Registry record updated Jan 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Critical Care PhysicianTaxonomy code 2086S0102X
License
62567 Issued in WI
Practice address
1836 South Ave
La Crosse, WI 54601-5429
Phone
(608) 782-7300
NPI assigned
Jun 29, 2008
Last updated
Jan 22, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 22, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X R-8454 IA
Surgery Physician 208600000X 62567 WI
Surgical Critical Care Physician 2086S0102X 62567 WI Primary

Addresses

Primary practice location

1836 South Ave
La Crosse, WI 54601-5429

Mailing address

1711 Madison St
La Crosse, WI 54601-4975
Phone (217) 971-4934

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, MN2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20141001001346 WI Practitioner - Critical Care (Intensivists)Practitioner - General Surgery 0840432415 Reassigns benefits to 3 organizations
I20260212002955 MN Practitioner - Critical Care (Intensivists)Practitioner - General Surgery 0840432415 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Critical Care (Intensivists)Also: General Surgery
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gundersen Lutheran Medical Center IncGroup PAC ID 2163331414, shared by 16 NPIs, 888 clinicians

Practice addresses (Care Compare)

1122 W Hwy 61
Winona, MN 55987-1957
Phone (507) 615-0600

1836 S Ave
La Crosse, WI 54601-5429
Phone (608) 783-7300

1910 S Ave
La Crosse, WI 54601-5467
Phone (608) 782-7300

2575 S 7TH St
Bethany Riverside
La Crosse, WI 54601-5429
Phone (608) 775-8200

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion1-10
Melanoma (skin cancer) excision1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R-8454IAMDSurgery Physician
62567WIMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Gundersen Lutheran Express Care, Inc CurrentSince Aug 25, 2014 Accepting new patients
Gundersen Lutheran Medical Center Inc Current Accepting new patients
Gundersen Lutheran Medical Center Inc CurrentSince Aug 25, 2014 Accepting new patients
St. Joseph's Health Services, Inc. CurrentSince Jan 25, 2026 Accepting new patients
Gundersen Clinic LTD CurrentSince Aug 25, 2014 Accepting new patients
Gundersen Lutheran Medical Center, Inc CurrentSince Aug 25, 2014 Accepting new patients
Gundersen Lutheran Medical Center Inc CurrentSince Mar 2, 2026 Accepting new patients
St. Joseph's Health Services, Inc. CurrentSince Jan 25, 2026 Accepting new patients
Gundersen Lutheran Medical Center, Inc. Past Accepting new patients

Locations

1122 W Highway 61
Winona, MN 55987
Phone (507) 615-0600

1836 South Ave
La Crosse, WI 54601
Phone (608) 788-8102

1910 South Ave
La Crosse, WI 54601
Phone (608) 775-2287

1600 Main St
Onalaska, WI 54650
Phone (608) 783-4681

Interoperability endpoints

  • Direct secure messaging: cwaller27222@direct.emplifyhealth.org

Organizations & group practices 9

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.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1214697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579651200000",
    "number": "1588826705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1711 MADISON ST",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "546014975",
            "telephone_number": "217-971-4934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1836 SOUTH AVE",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "546015429",
            "telephone_number": "608-782-7300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLER",
        "first_name": "CHRISTINE",
        "middle_name": "JOANNE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-06-29",
        "last_updated": "2020-01-22",
        "certification_date": "2020-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IA",
            "license": "R-8454",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "WI",
            "license": "62567",
            "primary": false
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "WI",
            "license": "62567",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Crosse, WI

Sources for this page

Verify at the official NPI Registry.