Individual provider Active NPI

Judy K Lottmann, MD

  • Surgery Physician
  • Sparta, WI
National Provider Identifier
1861498883
Registry record updated Jan 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
25090 Issued in WI
Practice address
315 W Oak St
Sparta, WI 54656-2150
Phone
(608) 269-6731
NPI assigned
Jun 23, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 25090 WI Primary

Addresses

Primary practice location

315 W Oak St
Sparta, WI 54656-2150

Mailing address

501 Gopher Dr
Tomah, WI 54660-4513
Phone (608) 723-2181

Other practice location 1

501 Gopher Dr
Tomah, WI 54660-4513
Phone (608) 723-2181

Other identifiers 1

IdentifierTypeStateIssuer
30299300MedicaidWI

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jlottmann13665@direct.monroeclinic.org Direct Tomah Memorial Hospital Inc

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
25090WIMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Gundersen Clinic LTD Past Accepting new patients

Organizations & group practices 1

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": "1119484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609718400000",
    "number": "1861498883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 GOPHER DR",
            "city": "TOMAH",
            "state": "WI",
            "postal_code": "546604513",
            "telephone_number": "608-723-2181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 W OAK ST",
            "city": "SPARTA",
            "state": "WI",
            "postal_code": "546562150",
            "telephone_number": "608-269-6731"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "501 Gopher Dr",
            "address_purpose": "LOCATION",
            "city": "Tomah",
            "state": "WI",
            "postal_code": "546604513",
            "country_code": "US",
            "telephone_number": "608-723-2181",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LOTTMANN",
        "first_name": "JUDY",
        "middle_name": "K",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-23",
        "last_updated": "2021-01-04",
        "certification_date": "2021-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "WI",
            "license": "25090",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30299300",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jlottmann13665@direct.monroeclinic.org",
            "affiliation": "Y",
            "affiliationName": "Tomah Memorial Hospital Inc",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "jlottmann13665@direct.monroeclinic.org",
            "address_1": "501 Gopher Dr",
            "city": "Tomah",
            "state": "WI",
            "country_code": "US",
            "postal_code": "546604513",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Sparta, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 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.