Active NPI
Mary Jane Wegman, BS
- Case Manager/Care Coordinator
- La Crosse, WI
National Provider Identifier
1619122942
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Case Manager/Care Coordinator
- License
- 2309 - 120
- Practice address
- 1407 Saint Andrew St Ste 100
La Crosse, WI 54603-2378 - Phone
- (608) 785-6266
- NPI assigned
- Dec 1, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | 2309 - 120 | WI | Primary |
Addresses
Primary practice location
1407 Saint Andrew St Ste 100
La Crosse, WI 54603-2378
Mailing address
W10242 Deer Print TRL
Black River Falls, WI 54615-5465
Phone (715) 284-5154
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Bachelor of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2309 - 120 | WI | MD | Case Manager/Care Coordinator |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| La Crosse County Cmo | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Health Maintenance Organization
- La Crosse, WI
- NPI 1225160492
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1228089600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1228089600000",
"number": "1619122942",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "W10242 DEER PRINT TRL",
"city": "BLACK RIVER FALLS",
"state": "WI",
"postal_code": "546155465",
"telephone_number": "715-284-5154"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1407 SAINT ANDREW ST STE 100",
"city": "LA CROSSE",
"state": "WI",
"postal_code": "546032378",
"telephone_number": "608-785-6266"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WEGMAN",
"first_name": "MARY",
"middle_name": "JANE",
"credential": "BS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-12-01",
"last_updated": "2008-12-01",
"status": "A"
},
"taxonomies": [
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": "WI",
"license": "2309 - 120",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in La Crosse, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.