Madison Mobile Wound Care Practice
Organization Active NPI Internal Medicine Physician · Madison, WI
NPI 1831945237 · NPPES record last updated May 23, 2024
Key facts
- NPI
- 1831945237
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Internal Medicine Physician 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
- Organization subpart
- No
Authorized official
- Name
- Kimberly L Olson, NP
- Title
- Advanced Practice Nurse Prescriber
- Phone
- (608) 577-2084
Practitioners 16
-
Laura E Ballweg, APNP
-
Angela M Besaw, NP
-
Morgan Godfrey, APNP
-
Sarah McBride, AG-CNS
-
Kristen Murdoch, DNP, FNP-BC
-
Kimberly L Olson, APNP
-
Kristy Marie Ross, APNP
-
Tracy L Jessogne, APNP
-
Amy Marie Pavelko, AGPCNP-BC
-
Meagan M Scheuing, APRN, CNP
-
Brian Harrison Gander, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (4 enrollments) in WI, IA, MN, MI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician |
207R00000X | Yes |
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
Other providers in Madison, WI
- Madison Home Care LLC
- Madison Manual Medicine, LTD.
- Madison Medical Supplies
- Madison Mental Health Services
- Madison Metropolitan School District
- Madison Neurology LLC
- Madison Neuropsychological Services LLC
- Madison Oral & Maxillofacial Surgeons SC
- Madison Pain Management
- Madison Pediatric Dental, SC
All providers in Madison, WI · Internal Medicine Physician in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 23, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.