Active NPI
Oakleaf Clinics Inc
- Family Medicine Physician
- Ladysmith, WI
National Provider Identifier
1669238754
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- Legal business name
- OAKLEAF CLINICS INC
- Practice address
- 1101 Lake Ave W
Ladysmith, WI 54848-1062 - Phone
- (715) 552-9784
- NPI assigned
- Feb 26, 2024
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Chris Longbella, MD
- Title
- Authorized Official
- Phone
- (715) 836-9242
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | Primary |
Addresses
Primary practice location
1101 Lake Ave W
Ladysmith, WI 54848-1062
Mailing address
719 W Hamilton Ave Ste B
Eau Claire, WI 54701-6970
Phone (715) 552-9784
Other names 1
- Oakleaf Clinics Ladysmith
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20110602000195 | WI | Part B Supplier - Clinic/Group Practice | 4486831328 |
Receives reassigned benefits from 120 practitioners 15 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Rice Lake, WI; Menomonie, WI; Ladysmith, WI; Eau Claire, WI; Cornell, WI; Chippewa Falls, WI; Altoona, WI |
Other NPIs on the same Medicare enrollment 15
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Family Medicine Physician
- Eau Claire, WI
- NPI 1053340067
Family Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1708905600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1708905600000",
"number": "1669238754",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "719 W HAMILTON AVE STE B",
"city": "EAU CLAIRE",
"state": "WI",
"postal_code": "547016970",
"telephone_number": "715-552-9784",
"fax_number": "715-835-6370"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1101 LAKE AVE W",
"city": "LADYSMITH",
"state": "WI",
"postal_code": "548481062",
"telephone_number": "715-552-9784"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "OAKLEAF CLINICS INC",
"organizational_subpart": "NO",
"enumeration_date": "2024-02-26",
"last_updated": "2024-02-26",
"certification_date": "2024-02-26",
"status": "A",
"authorized_official_last_name": "LONGBELLA",
"authorized_official_first_name": "CHRIS",
"authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
"authorized_official_telephone_number": "715-836-9242",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Family Medicine",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Oakleaf Clinics Ladysmith",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Ladysmith, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 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.