Individual provider Active NPI

Trista Marie Williams, AU.D.

  • Audiologist
  • La Crosse, WI
National Provider Identifier
1801295092
Registry record updated Sep 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
596-156 Issued in WI
Practice address
800 West Ave S
La Crosse, WI 54601-8806
Phone
(171) 583-8363
NPI assigned
Aug 14, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 596-156 WI Primary

Addresses

Primary practice location

800 West Ave S
La Crosse, WI 54601-8806

Mailing address

PO Box 1510
Eau Claire, WI 54702-1510
Phone (715) 838-3635

Other names 1

  • Trista Fugate Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address twilliams33548@ehrdirect.mayoclinicmsg.org

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151103000809 WI Practitioner - Qualified Audiologist 6507189503 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

800 W Ave S
La Crosse, WI 54601-8806
Phone (608) 785-0940

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Mayo Clinic Health System-Southwest Wisconsin Region, Inc. CurrentSince Oct 2, 2017 Accepting new patients
Mayo Clinic Health System-Southwest Wisconsin Region, Inc. CurrentSince Oct 2, 2017 Accepting new patients

Locations

800 West Ave S
La Crosse, WI 54601
Phone (608) 372-5951

705 E Taylor St
Prairie du Chien, WI 53821
Phone (608) 357-2000

800 E Blackhawk Ave
Prairie du Chien, WI 53821
Phone (608) 326-0808

310 W Main St
Sparta, WI 54656
Phone (608) 269-1700

Interoperability endpoints

  • Direct secure messaging: twilliams33548@ehrdirect.mayoclinicmsg.org

Organizations & group practices 2

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": "1407974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600214400000",
    "number": "1801295092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1510",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "547021510",
            "telephone_number": "715-838-3635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 WEST AVE S",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "546018806",
            "telephone_number": "171-583-8363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "TRISTA",
        "middle_name": "MARIE",
        "credential": "AU.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-14",
        "last_updated": "2020-09-16",
        "certification_date": "2020-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "WI",
            "license": "596-156",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "twilliams33548@ehrdirect.mayoclinicmsg.org",
            "affiliation": "N",
            "address_1": "800 West Ave S",
            "city": "LA Crosse",
            "state": "WI",
            "country_code": "US",
            "postal_code": "546018806",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "TRISTA",
            "last_name": "FUGATE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in La Crosse, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.