NPIMap

Organization Active NPI

Gundersen Clinic, LTD.

  • Clinic/Center
  • Prairie Du Chien, WI
National Provider Identifier
1972554590
Registry record updated Aug 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
GUNDERSEN CLINIC, LTD.
Practice address
610 E Taylor St
Prairie Du Chien, WI 53821-2109
Phone
(608) 782-7300
NPI assigned
May 16, 2006
Last updated
Aug 6, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
GUNDERSEN CLINIC LTDAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 6, 2021

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

Authorized official

Name
Kari B Adank
Title
Cco
Phone
(608) 775-8025

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary
Durable Medical Equipment & Medical Supplies 332B00000X

Addresses

Primary practice location

610 E Taylor St
Prairie Du Chien, WI 53821-2109

Mailing address

1836 South Ave
La Crosse, WI 54601-5429
Phone (608) 782-7300

Other names 1

  • GL Prairie Du Chien Clinic Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20031106000139 WI Part B Supplier - Clinic/Group Practice 9638082779 Receives reassigned benefits from 1,052 practitioners
19 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
O20100930050888 WI DME Supplier - Multi-Specialty - PhysicianDME Supplier - Physician - Family Practice 9638082779 Practice locations: Prairie Du Chien, WI

Other NPIs on the same Medicare enrollment 19

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 19

National Provider Directory

National Provider Directory
Tax ID family
Gunderson Decorah Podiatry53 organizations share this tax ID, including this one
Part of
Gunderson Decorah Podiatry

Organizations with this tax ID in the same state 12

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

Locations

626 Main St
Mc Gregor, IA 52157
Phone (563) 873-3411

1836 South Ave
Ste 1
La Crosse, WI 54601

1260 Crossing Meadows Dr
Onalaska, WI 54650
Phone (608) 775-5858

Practitioners & affiliated clinicians

Practitioners 29

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 29

NPI Registry JSON

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

{
    "created_epoch": "1147737600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1628208000000",
    "number": "1972554590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1836 SOUTH AVE",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "546015429",
            "telephone_number": "608-782-7300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 E TAYLOR ST",
            "city": "PRAIRIE DU CHIEN",
            "state": "WI",
            "postal_code": "538212109",
            "telephone_number": "608-782-7300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GUNDERSEN CLINIC, LTD.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GUNDERSEN CLINIC LTD",
        "enumeration_date": "2006-05-16",
        "last_updated": "2021-08-06",
        "certification_date": "2021-08-06",
        "status": "A",
        "authorized_official_last_name": "ADANK",
        "authorized_official_first_name": "KARI",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "CCO",
        "authorized_official_telephone_number": "608-775-8025"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GL Prairie Du Chien Clinic",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Prairie Du Chien, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2021; 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.