NPIMap

Organization Active NPI

Madison Mobile Wound Care Practice

  • Internal Medicine Physician
  • Madison, WI
National Provider Identifier
1831945237
Registry record updated May 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
MADISON MOBILE WOUND CARE PRACTICE
Practice address
401 New Castle Way
Madison, WI 53704-6070
Phone
(608) 577-2084
NPI assigned
Apr 25, 2024
Last updated
May 23, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 23, 2024

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

Authorized official

Name
Kimberly L Olson, NPNPI 1003689498
Title
Advanced Practice Nurse Prescriber
Phone
(608) 577-2084

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X Primary

Addresses

Primary practice location

401 New Castle Way
Madison, WI 53704-6070

Mailing address

PO Box 8334
Madison, WI 53708-8334
Phone (608) 577-2084

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, IA, MN, MI4 enrollments

Enrollment records 4

Enrollment IDStateProvider typePAC IDDetails
O20240703002887 WI Part B Supplier - Clinic/Group Practice 8628512407 Receives reassigned benefits from 14 practitioners
Practice locations: Madison, WI
O20250703001132 IA Part B Supplier - Clinic/Group Practice 8628512407 Receives reassigned benefits from 1 practitioner
Practice locations: Spirit Lake, IA
O20250902002775 MN Part B Supplier - Clinic/Group Practice 8628512407 Receives reassigned benefits from 2 practitioners
Practice locations: Heron Lake, MN
O20250913000181 MI Part B Supplier - Clinic/Group Practice 8628512407 Receives reassigned benefits from 1 practitioner
Practice locations: Ishpeming, MI

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 16

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1714003200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716422400000",
    "number": "1831945237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8334",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537088334",
            "telephone_number": "608-577-2084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 NEW CASTLE WAY",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537046070",
            "telephone_number": "608-577-2084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MADISON MOBILE WOUND CARE PRACTICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-25",
        "last_updated": "2024-05-23",
        "certification_date": "2024-05-23",
        "status": "A",
        "authorized_official_last_name": "OLSON",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "ADVANCED PRACTICE NURSE PRESCRIBER",
        "authorized_official_telephone_number": "608-577-2084",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2024; 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.