GUNDERSEN LUTHERAN MEDICAL CENTER INC (NPI# 1376886465) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376886465 |
| Entity Type | Organization |
| Organization Name | GUNDERSEN LUTHERAN MEDICAL CENTER INC |
| Other Organization Name | GLMC PRAIRIE DU CHIEN RENAL DIALYSIS |
| Practice Address |
610 E Taylor St Prairie Du Chien WI 53821-2109 |
| Mailing Address |
1910 South Ave La Crosse WI 54601-5467 |
| Practice Telephone | 6087827300 |
| Mailing Telephone | 6087827300 |
| Enumeration Date | 2013-03-27 |
| Last Update Date | 2016-03-06 |
| Authorized Official Name | KARI B ADANK (CCO) |
| Authorized Official Telephone | 6087752061 |
| Is Organization Subpart | Y |
| Parent Organization Name | GUNDERSEN LUTHERAN MEDICAL CENTER INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QE0700X |
Clinic/Center Specialization: End-Stage Renal Disease (ESRD) Treatment |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 42051000 | 05 |
| Other Name | Type Code |
|---|---|
| GLMC PRAIRIE DU CHIEN RENAL DIALYSIS | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700281045 | Gundersen Lutheran Medical Center Inc | Rehabilitation Unit | 1843 Sims Pl, La Crosse, WI 54601-6276 | 2014-10-29 |
| 1972846087 | Gundersen Lutheran Medical Center Inc | Clinic/Center | 505 Gopher Dr Ste B, Tomah, WI 54660-4513 | 2013-03-27 |
| 1003159195 | Gundersen Lutheran Medical Center Inc | Clinic/Center | 407 S Main St Ste 300, Viroqua, WI 54665-4001 | 2013-03-27 |
| 1215270327 | Gundersen Lutheran Medical Center Inc | Clinic/Center | 3075 S Kinney Coulee Rd, Onalaska, WI 54650-8677 | 2013-03-27 |
| 1952959603 | Gundersen Lutheran Medical Center Inc | Clinic/Center | 1122 W Highway 61, Winona, MN 55987-1957 | 2019-08-27 |
| 1063755171 | Gundersen Lutheran Medical Center Inc | Clinic/Center | 711 W Adams St, Black River Falls, WI 54615-9108 | 2013-03-27 |
| 1023358439 | Gundersen Lutheran Medical Center Inc | Clinic/Center | 1313 W Seminary St, Richland Center, WI 53581-2067 | 2013-02-21 |
| 1376593442 | Gundersen Lutheran Medical Center Inc | Clinic/Center | 1910 South Ave, La Crosse, WI 54601 | 2006-05-11 |
| Street Address |
610 E TAYLOR ST |
| City | PRAIRIE DU CHIEN |
| State | WI |
| Zip Code | 53821-2109 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295739035 | Ralph E Tauke | Internal Medicine | 610 E Taylor St, Prairie Du Chien, WI 53821-2109 | 2005-06-09 |
| 1841809316 | Kelsey Ann Hamann | Pharmacist | 610 E Taylor St, Prairie Du Chien, WI 53821-2109 | 2020-07-30 |
| 1861057846 | Anton Thies Breunig | Physician Assistant | 610 E Taylor St, Prairie Du Chien, WI 53821-2109 | 2019-05-06 |
| 1669981296 | Molly Elizabeth Sandgren | Nurse Practitioner | 610 E Taylor St, Prairie Du Chien, WI 53821-2109 | 2017-09-27 |
| 1417367277 | Gundersen Clinic Ltd | Pharmacy | 610 E Taylor St, Prairie Du Chien, WI 53821-2109 | 2014-05-02 |
| 1881976041 | Tammy L Plondke | Nurse Practitioner | 610 E Taylor St, Prairie Du Chien, WI 53821-2109 | 2011-09-14 |
| 1750676342 | Christopher J Mees | Family Medicine | 610 E Taylor St, Prairie Du Chien, WI 53821-2109 | 2011-06-13 |
| 1427286129 | Amber M Crawford | Surgery | 610 E Taylor St, Prairie Du Chien, WI 53821 | 2009-07-01 |
| 1164620480 | Jennifer A Mclellan | Surgery | 610 E Taylor St, Prairie Du Chien, WI 53821-2109 | 2007-07-08 |
| 1952518144 | Tamara Lynn Holzer | Surgery | 610 E Taylor St, Prairie Du Chien, WI 53821-2109 | 2007-05-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821539107 | Morgan Jewell Faulkner | Occupational Therapist | 700 S. Fremont St., Prairie Du Chien, WI 53821 | 2017-03-20 |
| 1710397039 | Kristina Lorene Thompson | Podiatrist | 37868 Us-18, Prairie Du Chien, WI 53821 | 2014-05-08 |
| 1952551525 | Stacy L. Blackburn | Family Medicine | 800 Blackhawk Avenue, Prairie Du Chien, WI 53821 | 2008-09-19 |
| 1124276985 | Lori Knapp Crawford, Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 106 South Beaumont Rd, Prairie Du Chien, WI 53821 | 2008-09-05 |
| 1386774834 | Jan R Kieser | Dentist | 7265 Beaumont Rd, Prairie Du Chien, WI 53821 | 2007-03-06 |
| 1437239209 | Bruce Lee Pomerening | Dentist | 109 South Beaumont Rd, Prairie Du Chien, WI 53821 | 2006-10-16 |
| 1386738078 | Edwin Herbert Neumann | Optometrist | 38020 Hwy 18, Prairie Du Chien, WI 53821 | 2006-10-03 |
| 1063515179 | Dental Associates of Prairie Du Chien PC | Dentist | 820 S Marquette Rd, Prairie Du Chien, WI 53821 | 2006-09-06 |
| 1811947492 | Mayo Clinic Health System - Franciscan Medical Center, Inc. | Durable Medical Equipment & Medical Supplies | 800 East Blackhawk Avenue, Prairie Du Chien, WI 53821 | 2006-05-12 |
| 1497759070 | Sara J Rybarczyk | Internal Medicine | 610 East Taylor St, Prairie Du Chien, WI 53821 | 2005-06-10 |
| Find all providers in zip 53821 | ||||
| Taxonomy Code | 261QE0700X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | End-Stage Renal Disease (ESRD) Treatment |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679171599 | Dubuque Internal Medicine, PC | Clinic/Center | 190 N Orange St, Richland Center, WI 53581-2163 | 2020-10-13 |
| 1316570989 | Fresenius Medical Care Midwest Dialysis, LLC | Clinic/Center | 5125 W Morgan Ave, Greenfield, WI 53220-1540 | 2020-02-21 |
| 1992352082 | Fresenius Kidney Care Madison, LLC | Clinic/Center | 4600 American Pkwy Ste 102, Madison, WI 53718-8334 | 2019-08-22 |
| 1770040859 | Fresenius Medical Care Oshkosh, LLC | Clinic/Center | 2700 W 9th Ave Ste 101a, Oshkosh, WI 54904-7201 | 2019-02-26 |
| 1972008704 | Midwest Legacy Capital LLC | Clinic/Center | W4233 State Rd 54, Black Creek, WI 54106-8633 | 2018-03-26 |
| 1841792603 | Wisconsin Renal Care Group, L.L.C. | Clinic/Center | 17500 W Capitol Drive, Brookfield, WI 53045 | 2018-03-07 |
| 1992212286 | Total Renal Care Inc | Clinic/Center | 733 E Capitol Dr, Milwaukee, WI 53212 | 2018-01-08 |
| 1023527058 | Bio-medical Applications of Wisconsin, Inc. | Clinic/Center | 2831 Okeeffe Ave, Sun Prairie, WI 53590-7057 | 2017-09-21 |
| 1093234569 | Fresenius Medical Care Milwaukee, LLC | Clinic/Center | 2615 W Silver Spring Dr, Milwaukee, WI 53209-4219 | 2017-09-15 |
| 1770010928 | Total Renal Care Inc | Clinic/Center | 9127 N 76th St, Milwaukee, WI 53223-1905 | 2017-05-18 |
| Find all providers with the same taxonomy | ||||
| City | PRAIRIE DU CHIEN |
| Zip Code | 53821 |
Please comment or provide details below to improve the information on GUNDERSEN LUTHERAN MEDICAL CENTER INC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.