NPIMap

Individual provider Active NPI

Adam Lee Halverson, DO

  • Orthopaedic Foot and Ankle Surgery Physician
  • Wausau, WI
National Provider Identifier
1922340967
Registry record updated Jun 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Foot and Ankle Surgery PhysicianTaxonomy code 207XX0004X
License
69905-21 Issued in WI
Practice address
225000 Hummingbird Rd Ste 100
Wausau, WI 54401-2950
Phone
(715) 359-6442
Fax
(715) 393-0390
NPI assigned
Mar 16, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2021

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 69905 WI
Orthopaedic Foot and Ankle Surgery Physician 207XX0004X 34.012228 OH
Student in an Organized Health Care Education/Training Program 390200000X
Orthopaedic Foot and Ankle Surgery Physician 207XX0004X 69905-21 WI Primary

Addresses

Primary practice location

225000 Hummingbird Rd Ste 100
Wausau, WI 54401-2950

Mailing address

225000 Hummingbird Rd Ste 100
Wausau, WI 54401-2950
Phone (715) 359-6442

Other practice location 1

5100 W Broad St
Columbus, OH 43228-1607
Phone (614) 544-1000

Other practice location 2

300 Polaris Pkwy Ste 2000
Westerville, OH 43082
Phone (614) 895-8747

Other practice location 3

350 W Wilson Bridge Rd Ste 200
Worthington, OH 43085
Phone (614) 895-8747

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190621002732 WI Practitioner - Orthopedic Surgery 0446526420 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bone and Joint Clinic S.C.Group PAC ID 3678541919, 45 clinicians

Practice addresses (Care Compare)

225000 Hummingbird Rd
Suite 100
Wausau, WI 54401-2950
Phone (715) 359-6442

Hospital & facility affiliations

  • Aspirus Wausau Hospital Hospital, Wausau, WI, CCN 520030

Procedures performed for Medicare patients

ProcedureNumber of procedures
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
69905WIMDOrthopaedic Surgery Physician
69905-21WIMDOrthopaedic Foot and Ankle Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bone & Joint Clinic S.C. CurrentSince Aug 1, 2019 Accepting new patients
Bone & Joint Clinic S.C. Orthopaedic Surgery CurrentSince Aug 1, 2019 Accepting new patients
Footsource MD, LLC Past Accepting new patients

Locations

724 S 8th St
Medford, WI 54451
Phone (715) 748-2663

100 S Eagle Dr
Merrill, WI 54452
Phone (715) 358-1911

1767 Park Ave
Plover, WI 54467
Phone (715) 344-1260

1767 Park Ave
Ste 300
Plover, WI 54467
Phone (715) 344-1260

1767 Park Ave
#100
Plover, WI 54467
Phone (715) 344-1260

225000 Hummingbird Rd
Ste 100
Rib Mountain, WI 54401
Phone 71535964421615

225000 Hummingbird Rd
Ste 300
Rib Mountain, WI 54401
Phone (715) 359-7592

400 Westwood Dr
#100
Wausau, WI 54401
Phone (715) 393-0372

400 Westwood Dr
#200
Wausau, WI 54401
Phone (715) 261-0425

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.

Hospital & facility affiliations 10

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1363392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623888000000",
    "number": "1922340967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225000 HUMMINGBIRD RD STE 100",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544012950",
            "telephone_number": "715-359-6442",
            "fax_number": "715-393-0390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225000 HUMMINGBIRD RD STE 100",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544012950",
            "telephone_number": "715-359-6442",
            "fax_number": "715-393-0390"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5100 W Broad St",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432281607",
            "country_code": "US",
            "telephone_number": "614-544-1000",
            "fax_number": "614-544-1751",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "300 Polaris Pkwy Ste 2000",
            "address_purpose": "LOCATION",
            "city": "Westerville",
            "state": "OH",
            "postal_code": "43082",
            "country_code": "US",
            "telephone_number": "614-895-8747",
            "fax_number": "614-895-3246",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "350 W Wilson Bridge Rd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Worthington",
            "state": "OH",
            "postal_code": "43085",
            "country_code": "US",
            "telephone_number": "614-895-8747",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HALVERSON",
        "first_name": "ADAM",
        "middle_name": "LEE",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-03-16",
        "last_updated": "2021-06-17",
        "certification_date": "2021-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "WI",
            "license": "69905",
            "primary": false
        },
        {
            "code": "207XX0004X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Foot and Ankle Surgery",
            "state": "OH",
            "license": "34.012228",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207XX0004X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Foot and Ankle Surgery",
            "state": "WI",
            "license": "69905-21",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wausau, WI

Sources for this page

Verify at the official NPI Registry.