Organization Active NPI

LG Health

  • Health Service Clinic/Center
  • Madison, WI
National Provider Identifier
1629786959
Registry record updated Dec 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service Clinic/CenterTaxonomy code 261QH0100X
Legal business name
LG HEALTH
Practice address
811 E Washington Ave Ste 400
Madison, WI 53703-4028
Phone
(608) 213-4977
NPI assigned
Nov 7, 2022
Last updated
Dec 19, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2023

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

Authorized official

Name
Jefferson StanleyNPI 1881285435
Title
Director
Phone
(608) 213-4977

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Clinic/Center 261QH0100X NU Primary

Addresses

Primary practice location

811 E Washington Ave Ste 400
Madison, WI 53703-4028

Mailing address

811 E Washington Ave Ste 400
Madison, WI 53703-4028
Phone (608) 213-4977

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241220002430 WI Part B Supplier - Clinic/Group Practice 8921535568 Receives reassigned benefits from 1 practitioner
Practice locations: Madison, WI

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1667779200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1702944000000",
    "number": "1629786959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "811 E WASHINGTON AVE STE 400",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537034028",
            "telephone_number": "608-213-4977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "811 E WASHINGTON AVE STE 400",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537034028",
            "telephone_number": "608-213-4977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LG HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-07",
        "last_updated": "2023-12-19",
        "certification_date": "2023-12-19",
        "status": "A",
        "authorized_official_last_name": "STANLEY",
        "authorized_official_first_name": "JEFFERSON",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "608-213-4977"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2023; 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.