Gundersen Clinic, LTD.

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

GUNDERSEN CLINIC, LTD.

Practice address

35791 Osseo Rd
Independence, WI 54747-9096

Phone

(608) 782-7300

NPI assigned

May 17, 2006

Organization subpart

Yes

Parent organization

GUNDERSEN CLINIC, LTD.As reported in NPPES

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

Authorized official

Name

Kari B Adank

Title

Cco

Phone

(608) 775-8025

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• GL Independence Clinic Other name

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Part of

La Liberte-Gundersen VI

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1457308800000",
    "number": "1780636480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1836 SOUTH AVE",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "546015429",
            "telephone_number": "608-782-7300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35791 OSSEO RD",
            "city": "INDEPENDENCE",
            "state": "WI",
            "postal_code": "547479096",
            "telephone_number": "608-782-7300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GUNDERSEN CLINIC, LTD.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GUNDERSEN CLINIC, LTD.",
        "enumeration_date": "2006-05-17",
        "last_updated": "2016-03-07",
        "status": "A",
        "authorized_official_last_name": "ADANK",
        "authorized_official_first_name": "KARI",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "CCO",
        "authorized_official_telephone_number": "608-775-8025"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "43062500",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GL Independence Clinic",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• William J. Baxa
• Nicole Borreson
• County of Trempealeau
• County of Trempealeau
• County of Trempealeau
• Jody Erica Kroening, RN/DNP PMHNP-BC
• School District of Independence
• Trempealeau County Health Care Center
• Tri-County Memorial Hospital, Inc.
• Western Dairyland Eoc

• Clinic/Center in Independence, WI
• Providers in Independence, WI by specialty
• Clinic/Center in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.