Individual provider Active NPI

Katie J Udenberg, DO

  • Pediatrics Physician
  • Eau Claire, WI
National Provider Identifier
1699121384
Registry record updated Sep 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
71438-21 Issued in WI
Practice address
2116 Craig Rd
Eau Claire, WI 54701-6118
Phone
(715) 858-4610
NPI assigned
May 11, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 71438-21 WI Primary

Addresses

Primary practice location

2116 Craig Rd
Eau Claire, WI 54701-6118

Mailing address

1000 N Oak Ave
Marshfield, WI 54449-5703
Phone (715) 387-5511

Other practice location 1

1000 Oakland Dr
Kalamazoo, MI 49008-1282
Phone (269) 337-6019

Other practice location 2

3085 Meadowlark Ln Ste 20
Altoona, WI 54720-2656
Phone (715) 717-3350

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address him@marshfieldclinichealthsystem.cernerdirect.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190802002416 WI Practitioner - Pediatric Medicine 2062709389 Reassigns benefits to 9 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
71438-21WIMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Flambeau Hospital Inc CurrentSince Aug 9, 2024 Accepting new patients
Beaver Dam Community Hospitals Inc CurrentSince Aug 9, 2024 Accepting new patients
Marshfield Clinic Inc CurrentSince Aug 9, 2024 Accepting new patients
Flambeau Hospital Inc CurrentSince Aug 9, 2024 Accepting new patients
MCHS Hospitals Inc Current Accepting new patients
MCHS Hospitals Inc CurrentSince Aug 9, 2024 Accepting new patients
Lakeview Medical Center Inc of Rice Lake CurrentSince Aug 9, 2024 Accepting new patients
MCHS Hospitals Inc CurrentSince Aug 9, 2024 Accepting new patients
Lakeview Medical Center Inc of Rice Lake CurrentSince Aug 9, 2024 Accepting new patients
Memorial Hospital Inc CurrentSince Aug 9, 2024 Accepting new patients
Beaver Dam Community Hospitals Inc CurrentSince Aug 9, 2024 Accepting new patients
Memorial Hospital Inc Past Accepting new patients

Locations

705 S University Ave
Beaver Dam, WI 53916
Phone (920) 885-6090

2655 County Highway I
Chippewa Fls, WI 54729
Phone (715) 723-8827

2116 Craig Rd
Eau Claire, WI 54701
Phone (715) 858-4500

900 W Clairemont Ave
Eau Claire, WI 54701
Phone (715) 717-4121

3501 Golf Rd
Eau Claire, WI 54701
Phone (715) 858-4200

1000 N Oak Ave
Marshfield, WI 54449
Phone (715) 387-5111

1102 S Center Ave
Merrill, WI 54452
Phone (715) 536-3399

N3708 River Ave
Neillsville, WI 54456
Phone (715) 743-3101

1700 W Stout St
Rice Lake, WI 54868
Phone (715) 236-6133

Interoperability endpoints

  • Direct secure messaging: him@marshfieldclinichealthsystem.cernerdirect.com

Organizations & group practices 12

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.

NPI Registry JSON

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

{
    "created_epoch": "1462924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725494400000",
    "number": "1699121384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 N OAK AVE",
            "city": "MARSHFIELD",
            "state": "WI",
            "postal_code": "544495703",
            "telephone_number": "715-387-5511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2116 CRAIG RD",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "547016118",
            "telephone_number": "715-858-4610"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 Oakland Dr",
            "address_purpose": "LOCATION",
            "city": "Kalamazoo",
            "state": "MI",
            "postal_code": "490081282",
            "country_code": "US",
            "telephone_number": "269-337-6019",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3085 Meadowlark Ln Ste 20",
            "address_purpose": "LOCATION",
            "city": "Altoona",
            "state": "WI",
            "postal_code": "547202656",
            "country_code": "US",
            "telephone_number": "715-717-3350",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "UDENBERG",
        "first_name": "KATIE",
        "middle_name": "J",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-11",
        "last_updated": "2024-09-05",
        "certification_date": "2024-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WI",
            "license": "71438-21",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "him@marshfieldclinichealthsystem.cernerdirect.com",
            "affiliation": "N",
            "address_1": "2116 Craig Rd",
            "city": "Eau Claire",
            "state": "WI",
            "country_code": "US",
            "postal_code": "547016118",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Eau Claire, WI

Sources for this page

Verify at the official NPI Registry.