Western Wisconsin Medical Associates Hudson LTD

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

WESTERN WISCONSIN MEDICAL ASSOCIATES HUDSON LTD

Practice address

403 Stageline Road
Hudson, WI 54016

Phone

(715) 531-6800

Fax

(715) 531-6801

NPI assigned

Mar 29, 2006

Organization subpart

Yes

Parent organization

WESTERN WISCONSIN MEDICAL ASSOCIATES HUDSON LTDAs reported in NPPES

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

Authorized official

Name

Ernie Wallin

Title

Administrator Director

Phone

(715) 531-6800

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Hudson Physicians Doing business as

Part of

Western Wisconsin Medical Associates Hudson LTD

Practitioners 2

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

• Anthony C Hecht, MD

  • Gastroenterology Physician
  • New Richmond, WI
  • NPI 1922080217
  NPD
• Kirk L Jacobson, MD

  • Surgery Physician
  • Hudson, WI
  • NPI 1508839994
  NPD

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

{
    "created_epoch": "1143590400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1255392000000",
    "number": "1679534697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "403 STAGELINE ROAD",
            "city": "HUDSON",
            "state": "WI",
            "postal_code": "54016",
            "telephone_number": "715-531-6800",
            "fax_number": "715-531-6801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "403 STAGELINE ROAD",
            "city": "HUDSON",
            "state": "WI",
            "postal_code": "54016",
            "telephone_number": "715-531-6800",
            "fax_number": "715-531-6801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTERN WISCONSIN MEDICAL ASSOCIATES HUDSON LTD",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WESTERN WISCONSIN MEDICAL ASSOCIATES HUDSON LTD",
        "enumeration_date": "2006-03-29",
        "last_updated": "2009-10-13",
        "status": "A",
        "authorized_official_last_name": "WALLIN",
        "authorized_official_first_name": "ERNIE",
        "authorized_official_title_or_position": "ADMINISTRATOR DIRECTOR",
        "authorized_official_telephone_number": "715-531-6800"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "WI",
            "license": null,
            "primary": true
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "WI",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32723100",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "56125",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hudson Physicians",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Luke Allen Wernberg, DPT
• Brady Wernlund, D.C.
• Jeana Michele Wescott
• Patrick Paul Westerham, MSW, LCSW, LICSW
• Mary Ellen Westerlund, COTA
• Tamara Lynn Wettstein
• Shelly Dee Weyers, LPN
• Brian M. Whisler
• Charles Wiatr
• Kelly Marie Widule, OTR/L

• Multi-Specialty Clinic/Center in Hudson, WI
• Providers in Hudson, WI by specialty
• Multi-Specialty Clinic/Center in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.