Individual provider Active NPI

Amy M Ludwikowski, M.D.

  • Family Medicine Physician
  • Eau Claire, WI
National Provider Identifier
1801864467
Registry record updated Dec 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
42649 Issued in WI
Practice address
431 E Clairemont Ave Ste C
Eau Claire, WI 54701-6480
Phone
(715) 514-5724
Fax
(715) 514-5734
NPI assigned
Mar 9, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 42649 WI Primary

Addresses

Primary practice location

431 E Clairemont Ave Ste C
Eau Claire, WI 54701-6480

Mailing address

431 E Clairemont Ave Ste C
Eau Claire, WI 54701-6480
Phone (715) 514-5724

Other identifiers 2

IdentifierTypeStateIssuer
1801864467MedicaidWI
1801864467MedicaidMN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
42649WIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
KSB Medical Group, Inc. Past Accepting new patients
KSB Medical Group, Inc. Family Medicine Past Accepting new patients
St. Joseph'S Health Services, Inc. Past Accepting new patients

Organizations & group practices 3

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": "1141862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639612800000",
    "number": "1801864467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "431 E CLAIREMONT AVE STE C",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "547016480",
            "telephone_number": "715-514-5724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "431 E CLAIREMONT AVE STE C",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "547016480",
            "telephone_number": "715-514-5724",
            "fax_number": "715-514-5734"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUDWIKOWSKI",
        "first_name": "AMY",
        "middle_name": "M",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-09",
        "last_updated": "2021-12-16",
        "certification_date": "2021-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "42649",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1801864467",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1801864467",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Eau Claire, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2021; 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.