Active NPI
Wildwood Family Clinic, SC
- Family Medicine Physician
- Madison, WI
National Provider Identifier
1851300784
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- Legal business name
- WILDWOOD FAMILY CLINIC, SC
- Practice address
- 4901 Cottage Grove Rd
Madison, WI 53716-1392 - Phone
- (608) 221-1501
- Fax
- (608) 223-3540
- NPI assigned
- Aug 7, 2006
- Last updated
- Oct 21, 2026
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Jennifer Rein
- Title
- Credentialing Manager
- Phone
- (608) 221-1501
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | |||
| Family Medicine Physician | 207Q00000X | Primary |
Addresses
Primary practice location
4901 Cottage Grove Rd
Madison, WI 53716-1392
Mailing address
4901 Cottage Grove Rd
Madison, WI 53716-1392
Phone (608) 221-1501
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040920000493 | WI | Part B Supplier - Clinic/Group Practice | 9537137484 |
Receives reassigned benefits from 31 practitioners 1 other NPI on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Madison, WI |
Other NPIs on the same Medicare enrollment 1
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
-
- Family Medicine Physician
- Cottage Grove, WI
- NPI 1225115124
O20040920000493
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 52D0393727 | Wildwood Family Clinic | Compliance | May 27, 2027 |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 24
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.
-
- Family Medicine Physician
- Madison, WI
- NPI 1508824665
-
- Family Medicine Physician
- Madison, WI
- NPI 1194712786
-
- Family Medicine Physician
- Deforest, WI
- NPI 1659340719
-
- Orthopedic Physical Therapist
- Madison, WI
- NPI 1710922166
-
- Family Medicine Physician
- Madison, WI
- NPI 1558323592
-
- Mental Health Counselor
- Madison, WI
- NPI 1669981676
-
- Family Medicine Physician
- Cottage Grove, WI
- NPI 1689838492
-
- Family Medicine Physician
- Madison, WI
- NPI 1194946988
-
- Family Medicine Physician
- Madison, WI
- NPI 1801020425
-
- Medical Physician Assistant
- Cottage Grove, WI
- NPI 1467410902
-
- Physician Assistant
- Cottage Grove, WI
- NPI 1154586717
-
- Family Medicine Physician
- Madison, WI
- NPI 1245289008
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154908800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1792540800000",
"number": "1851300784",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4901 COTTAGE GROVE RD",
"city": "MADISON",
"state": "WI",
"postal_code": "537161392",
"telephone_number": "608-221-1501",
"fax_number": "608-223-3540"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4901 COTTAGE GROVE RD",
"city": "MADISON",
"state": "WI",
"postal_code": "537161392",
"telephone_number": "608-221-1501",
"fax_number": "608-223-3540"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "WILDWOOD FAMILY CLINIC, SC",
"organizational_subpart": "NO",
"enumeration_date": "2006-08-07",
"last_updated": "2026-10-21",
"certification_date": "2026-10-21",
"status": "A",
"authorized_official_last_name": "REIN",
"authorized_official_first_name": "JENNIFER",
"authorized_official_title_or_position": "CREDENTIALING MANAGER",
"authorized_official_telephone_number": "608-221-1501"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Social Worker, Clinical",
"state": null,
"license": null,
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Family Medicine",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Madison, WI
- Wilder Chiropractic, Inc. (Madison Chiropractic East Madison Chiropractic West)
- Jeffrey M. Wilder, D.C.
- Lindsay J Wilder, MACCC-SLP
- Wildflower Expressive Arts Therapies LLC
- George Wilding, MD
- Michael Wilhelm
- Susan R Wilhelm, PA-C
- Jacqueline Wilhelmi-Carpenter, MSSW
- Linda Wilhelmi, LCSW
- Tara H Wilhelmi, CPSS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2026; 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.