NPIMap

Organization Active NPI

Gundersen Clinic, LTD.

  • Clinic/Center
  • Whitehall, WI
National Provider Identifier
1609828151
Registry record updated May 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
GUNDERSEN CLINIC, LTD.
Practice address
18606 Ervin St
Whitehall, WI 54773-8613
Phone
(608) 782-7300
NPI assigned
May 16, 2006
Last updated
May 12, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
GUNDERSEN CLINIC, LTDAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 12, 2022

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

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X WI Primary
Durable Medical Equipment & Medical Supplies 332B00000X

Addresses

Primary practice location

18606 Ervin St
Whitehall, WI 54773-8613

Mailing address

1836 South Ave
La Crosse, WI 54601-5429
Phone (608) 782-7300

Other names 1

  • GL Whitehall Clinic Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20031106000139 WI Part B Supplier - Clinic/Group Practice 9638082779 Receives reassigned benefits from 1,052 practitioners
19 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
O20100930050892 WI DME Supplier - Physician - OptometristDME Supplier - Physician - OphthalmologyDME Supplier - Optician 9638082779 Practice locations: Whitehall, WI

Other NPIs on the same Medicare enrollment 19

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 19

National Provider Directory

National Provider Directory
Part of
Gunderson Decorah Podiatry

Locations

400 Mason St
Ste 200
Onalaska, WI 54650
Phone (608) 775-8140

18606 Ervin St
Ste 696
Whitehall, WI 54773

Practitioners & affiliated clinicians

Practitioners 18

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1147737600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1652313600000",
    "number": "1609828151",
    "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": "18606 ERVIN ST",
            "city": "WHITEHALL",
            "state": "WI",
            "postal_code": "547738613",
            "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": "2006-05-16",
        "last_updated": "2022-05-12",
        "certification_date": "2022-05-12",
        "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": "WI",
            "license": null,
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GL Whitehall Clinic",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "GL Whitehall Clinic",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Whitehall, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.