NPIMap

Organization Active NPI

Krohn Clinic LTD.

  • Family Medicine Physician
  • Black River Falls, WI
National Provider Identifier
1790777621
Registry record updated Aug 28, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
KROHN CLINIC LTD.
Practice address
610 W Adams St
Black River Falls, WI 54615-9010
Phone
(715) 284-4311
Fax
(715) 284-0475
NPI assigned
Aug 17, 2005
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Mrs. Sandra K Salsman
Title
Director of Finance
Phone
(715) 284-4311

Practitioners 20

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

View all 20

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040119000050 WI Part B Supplier - Clinic/Group Practice 3577464916 Receives reassigned benefits from 19 practitioners
Practice locations: Black River Falls, WI

National Provider Directory

National Provider Directory

Locations

711 W Adams St
Blk River Fls, WI 54615
Phone (715) 284-1302

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BHJBDA

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

NPPES NPI Registry

Primary practice location

610 W Adams St
Black River Falls, WI 54615-9010

Mailing address

610 W Adams St
Black River Falls, WI 54615-9010
Phone (715) 284-4311

Other identifiers 2

NPPES NPI Registry
IdentifierTypeStateIssuer
0580630001OtherWIMEDICARE - DMEPOS
32726800MedicaidWI

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 28, 2019.

{
    "created_epoch": "1124236800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1566950400000",
    "number": "1790777621",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "610 W ADAMS ST",
            "city": "BLACK RIVER FALLS",
            "state": "WI",
            "postal_code": "546159010",
            "telephone_number": "715-284-4311",
            "fax_number": "715-284-2568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 W ADAMS ST",
            "city": "BLACK RIVER FALLS",
            "state": "WI",
            "postal_code": "546159010",
            "telephone_number": "715-284-4311",
            "fax_number": "715-284-0475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KROHN CLINIC LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-17",
        "last_updated": "2019-08-28",
        "status": "A",
        "authorized_official_last_name": "SALSMAN",
        "authorized_official_first_name": "SANDRA",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "DIRECTOR OF FINANCE",
        "authorized_official_telephone_number": "715-284-4311",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE - DMEPOS",
            "identifier": "0580630001",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32726800",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Black River Falls, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2019; 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.