NPIMap

Organization Active NPI

Oakleaf Clinics Inc

Doing business as Oakleaf Clinics, Pine Grove Family Medicine

  • Family Medicine Physician
  • Eau Claire, WI
National Provider Identifier
1679014294
Registry record updated Sep 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
OAKLEAF CLINICS INC
Doing business as
Oakleaf Clinics, Pine Grove Family Medicine
Practice address
3221 Stein Blvd
Eau Claire, WI 54701-4398
Phone
(715) 834-2788
NPI assigned
Mar 15, 2017
Last updated
Sep 21, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
OAKLEAF CLINICS INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 21, 2022

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

Authorized official

Name
Dr. Chris R Longbella, M.D.NPI 1992804413
Title
Director
Phone
(715) 836-9242

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

3221 Stein Blvd
Eau Claire, WI 54701-4398

Mailing address

719 W Hamilton Ave Ste B
Eau Claire, WI 54701-6970
Phone (715) 552-9784

Other practice location 1

2741 N Clairemont Ave
Eau Claire, WI 54703-2594
Phone (715) 834-0711

Other names 2

  • Oakleaf Clinics, Pine Grove Family Medicine Doing business as
  • Oakleaf Clinics SC-Pine Grove Family Medicine Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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.

View all 15

National Provider Directory

National Provider Directory
Part of
Oakleaf Clinics Inc

Locations

3119 Golf Rd
Ste 107
Eau Claire, WI 54701
Phone (715) 514-2833

Practitioners & affiliated clinicians

Practitioners 30

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.

View all 30

NPI Registry JSON

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

{
    "created_epoch": "1489536000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663718400000",
    "number": "1679014294",
    "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": "3221 STEIN BLVD",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "547014398",
            "telephone_number": "715-834-2788"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2741 N Clairemont Ave",
            "address_purpose": "LOCATION",
            "city": "Eau Claire",
            "state": "WI",
            "postal_code": "547032594",
            "country_code": "US",
            "telephone_number": "715-834-0711",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "OAKLEAF CLINICS INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "OAKLEAF CLINICS INC",
        "enumeration_date": "2017-03-15",
        "last_updated": "2022-09-21",
        "certification_date": "2022-08-31",
        "status": "A",
        "authorized_official_last_name": "LONGBELLA",
        "authorized_official_first_name": "CHRIS",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "715-836-9242",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "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, Pine Grove Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Oakleaf Clinics SC-Pine Grove Family Medicine",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Eau Claire, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2022; 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.