Gundersen Clinic, LTD.
Organization Active NPI Clinic/Center · Whitehall, WI
NPI 1609828151 · NPPES record last updated May 12, 2022
Key facts
- NPI
- 1609828151
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Clinic/Center 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
- Organization subpart
- Yes
- Parent organization (as reported)
- GUNDERSEN CLINIC, LTD
Authorized official
- Name
- Kari B Adank
- Title
- Cco
- Phone
- (608) 775-8025
Other NPIs on the same Medicare enrollment 19
Practitioners 18
-
Hilary Anne Conn, CNM
-
Joshua Dewey, PA-C
-
Erin L Maslowski, MD
-
Angela Marie Onsgard, R.D.
-
Katherine Frances Peters, AGNP
-
Suren Ravuri, MD
-
Kevin M Rumball, MD
-
Eric Michael Schauberger, D.O., PH.D.
-
Lee Vue, DNP
-
Devin S Wenrich, M.D.
-
Harvey A.J. Hopkins, M.D.
-
Jean M Tobin, PA-C
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in WI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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 - Optometrist |
9638082779 | Practice locations: Whitehall, WI |
National Provider Directory
- Part of
- La Liberte-Gundersen VI
Locations
2500 State Rd
La Crosse, WI 54601
Phone (608) 775-5858
175 E Mill St
Richland Ctr, WI 53581
Phone (608) 647-6222
18606 Ervin St
Ste 696
Whitehall, WI 54773
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinic/Center | 261Q00000X | WI | Yes | |
| 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 identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 43062400 | Medicaid | WI |
Other names
- GL Whitehall Clinic
Other providers in Whitehall, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 12, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.