Willow Creek Womens Clinic SC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

85943 030 NP Issued in WI

Legal business name

WILLOW CREEK WOMENS CLINIC SC

Practice address

1470 Rivers Edge TRL Ste 3
Altoona, WI 54720-2755

Phone

(715) 832-9292

Fax

(715) 832-4172

NPI assigned

Jan 23, 2007

Organization subpart

No

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

Authorized official

Name

Linda Fossum, RN FNPC APNP

Title

Owner

Phone

(715) 832-9292

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Locations

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Heather Conn, FNP-C

  • Family Nurse Practitioner
  • Altoona, WI
  • NPI 1790155182
  Medicare reassignment NPD
• Amy Marie Marvin, FNP-C

  • Family Nurse Practitioner
  • Altoona, WI
  • NPI 1447820626
  Medicare reassignment NPD
• Linda Poirier, RN FNPC APNP

  • Nurse Practitioner
  • Eau Claire, WI
  • NPI 1477606242
  Medicare reassignment NPD
• Hope Saeger, RN, APNP

  • Nurse Practitioner
  • Eau Claire, WI
  • NPI 1851580286
  Medicare reassignment NPD
• Allison Wilson, NP

  • Family Nurse Practitioner
  • Philadelphia, PA
  • NPI 1558786129

  WI

  Medicare reassignment NPD
• Wendy Sue Brousseau-Anderson, LMFT

  • Marriage & Family Therapist
  • Eau Claire, WI
  • NPI 1164166518
  NPD (past)

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718928000000",
    "number": "1609920743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1470 RIVERS EDGE TRL STE 3",
            "city": "ALTOONA",
            "state": "WI",
            "postal_code": "547202755",
            "telephone_number": "715-832-9292",
            "fax_number": "715-832-4172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1470 RIVERS EDGE TRL STE 3",
            "city": "ALTOONA",
            "state": "WI",
            "postal_code": "547202755",
            "telephone_number": "715-832-9292",
            "fax_number": "715-832-4172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLOW CREEK WOMENS CLINIC SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-23",
        "last_updated": "2024-06-21",
        "certification_date": "2024-06-21",
        "status": "A",
        "authorized_official_last_name": "FOSSUM",
        "authorized_official_first_name": "LINDA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "715-832-9292",
        "authorized_official_credential": "RN FNPC APNP"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "684 033 APNP",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "85943 030 NP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "43898700",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cindi Weisenberger, NP
• Valerie Whitehead, RN
• Courtney Wieland, PTA
• Ellisa Wilbur, BCBA
• Amber Willmarth, NP
• Alyssa Ann Zank, OTR/L
• Brianna Zey, BCBA
• Megan Ziemann, M.S. SLP-CCC

• Nurse Practitioner in Altoona, WI
• Providers in Altoona, WI by specialty
• Nurse Practitioner in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2024; 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.