NPIMap

Organization Active NPI

Gundersen Clinic, LTD.

  • Clinic/Center
  • Decorah, IA
National Provider Identifier
1982657458
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
1830 State Highway 9
Decorah, IA 52101-7301
Phone
(608) 782-7300
NPI assigned
May 18, 2006
Last updated
Aug 6, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
GUNDERSEN CLINIC, LTD.As 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 NU Primary
Durable Medical Equipment & Medical Supplies 332B00000X NU

Addresses

Primary practice location

1830 State Highway 9
Decorah, IA 52101-7301

Mailing address

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

Other names 1

  • GL Decorah Clinic Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040130000561 IA Part B Supplier - Clinic/Group Practice 9638082779 Receives reassigned benefits from 191 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Lansing, IA; McGregor, IA; Monona, IA; Oelwein, IA; Ossian, IA; Postville, IA; Waukon, IA; Decorah, IA…
O20100930038086 IA DME Supplier - Multi-Specialty - Physician 9638082779 Practice locations: Decorah, IA

Other NPIs on the same Medicare enrollment 2

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

National Provider Directory

National Provider Directory
Tax ID family
Gundersen Lutheran-Toma52 organizations share this tax ID, including this one
Part of
Gundersen Lutheran-Toma

Organizations with this tax ID in the same state 6

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

Practitioners & affiliated clinicians

Practitioners 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1628208000000",
    "number": "1982657458",
    "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": "1830 STATE HIGHWAY 9",
            "city": "DECORAH",
            "state": "IA",
            "postal_code": "521017301",
            "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": "2006-05-18",
        "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": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GL Decorah Clinic",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Decorah, IA

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.