GUNDERSEN CLINIC LTD (NPI# 1619200631) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619200631 |
| Entity Type | Organization |
| Organization Name | GUNDERSEN CLINIC LTD |
| Other Organization Name | GUNDERSEN CLINIC MOBILE MAMMO UNIT |
| Practice Address |
1836 South Ave La Crosse WI 54601-5429 |
| Practice Telephone | 6087827300 |
| Practice Fax Number | 6087757440 |
| Mailing Telephone | 6087827300 |
| Mailing Fax Number | 6087757440 |
| Enumeration Date | 2009-09-09 |
| Last Update Date | 2016-03-07 |
| Authorized Official Name | KARI B ADANK (CCO) |
| Authorized Official Telephone | 6087758025 |
| Is Organization Subpart | Y |
| Parent Organization Name | GUNDERSEN CLINIC LTD |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR0207X |
Clinic/Center Specialization: Radiology, Mobile Mammography |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| GUNDERSEN CLINIC MOBILE MAMMO UNIT | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952915639 | Gundersen Clinic Ltd | Clinic/Center | 2615 George St, La Crosse, WI 54603-1670 | 2020-09-01 |
| 1225503428 | Gundersen Clinic Ltd | Pharmacy | 123 Hale Dr Ste 1, Holmen, WI 54636-8933 | 2018-10-04 |
| 1396234837 | Gundersen Clinic Ltd | Optometrist | 402a W Lake St, Friendship, WI 53934 | 2018-05-09 |
| 1396099065 | Gundersen Clinic Ltd | Clinic/Center | 108 S 3rd St, Arcadia, WI 54612 | 2012-11-02 |
| 1235773136 | Gundersen Clinic Ltd | Pharmacy | 1122 W Highway 61 Ste A, Winona, MN 55987-1957 | 2019-11-04 |
| 1164080099 | Gundersen Clinic Ltd | Clinic/Center | 201 3rd St N, La Crosse, WI 54601-3208 | 2019-06-05 |
| 1952967358 | Gundersen Clinic Ltd | Pharmacy | 505 Gopher Dr Ste A, Tomah, WI 54660-4513 | 2019-05-13 |
| 1245705441 | Gundersen Clinic Ltd | Pharmacy | 2511 Green Bay St, La Crosse, WI 54601-5900 | 2018-10-04 |
| 1497220693 | Gundersen Clinic Ltd | Pharmacy | 111 Sand Lake Rd, Onalaska, WI 54650-2760 | 2018-10-04 |
| 1306347141 | Gundersen Clinic Ltd | Clinic/Center | 516 Montgomery St, Decorah, IA 52101-2720 | 2018-02-27 |
| Street Address |
1836 SOUTH AVE |
| City | LA CROSSE |
| State | WI |
| Zip Code | 54601-5429 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952304834 | Susan G Maclellan-tobert | Pediatrics | 1836 South Ave, La Crosse, WI 54601-5429 | 2005-05-24 |
| 1861099590 | Ellen Compton | Dietitian, Registered | 1836 South Ave, La Crosse, WI 54601-5429 | 2020-10-06 |
| 1699382630 | Jedd Sebion | Pharmacist | 1836 South Ave, La Crosse, WI 54601-5429 | 2020-09-24 |
| 1104436351 | Taryn Jean Simon | Speech-Language Pathologist | 1836 South Ave, La Crosse, WI 54601-5429 | 2020-08-03 |
| 1497376438 | Eva Igler | Student in an Organized Health Care Education/Training Program | 1836 South Ave, La Crosse, WI 54601-5429 | 2020-04-30 |
| 1568083608 | Benjamin Haase Thompson | Student in an Organized Health Care Education/Training Program | 1836 South Ave, La Crosse, WI 54601-5429 | 2020-04-29 |
| 1316568736 | Eric Bobel | Student in an Organized Health Care Education/Training Program | 1836 South Ave, La Crosse, WI 54601-5429 | 2020-04-27 |
| 1134749708 | Kristin Danielle Heslep | Student in an Organized Health Care Education/Training Program | 1836 South Ave, La Crosse, WI 54601-5429 | 2020-04-23 |
| 1982224598 | Rebecca Stanek | Student in an Organized Health Care Education/Training Program | 1836 South Ave, La Crosse, WI 54601-5429 | 2020-04-23 |
| 1609496595 | Marie Gilberte Cineus | Student in an Organized Health Care Education/Training Program | 1836 South Ave, La Crosse, WI 54601-5429 | 2020-04-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891324265 | Meagan Mcrae | Student in an Organized Health Care Education/Training Program | 1725 State St., 4051 Health Science Center, La Crosse, WI 54601 | 2020-04-07 |
| 1255969671 | Erin Dingman | Student in an Organized Health Care Education/Training Program | 1751 State Street, 4051 Health Science Center, La Crosse, WI 54601 | 2020-03-31 |
| 1619505047 | Nicole Kay Lynch | Student in an Organized Health Care Education/Training Program | 4051 Health Science Center, 1725 State St, La Crosse, WI 54601 | 2020-03-31 |
| 1174151757 | Jenna Sells | Student in an Organized Health Care Education/Training Program | 4051 Health Science Center, 1725 State Street, La Crosse, WI 54601 | 2020-03-30 |
| 1740818301 | Katie Irene Tahtinen | Student in an Organized Health Care Education/Training Program | Uwl- 4051 Health Science Center, 1725 State St., La Crosse, WI 54601 | 2020-03-30 |
| 1932737517 | Margaret May Grimm | Student in an Organized Health Care Education/Training Program | Univesity of Wisconsin-la Crosse, 4051 Health Science Center, 1725 State Street, La Crosse, WI 54601 | 2020-03-30 |
| 1831727312 | Matthew Timothy Axler | Student in an Organized Health Care Education/Training Program | 4051 Health Science Center, 1725 State Street, La Crosse, WI 54601 | 2020-03-30 |
| 1093340473 | Denise Stinson | Technician | 1311 Badger St, Apt 505, La Crosse, WI 54601 | 2020-03-06 |
| 1922632397 | Ibrahim Ahsan | Pharmacist | 1105 Wi-16, La Crosse, WI 54601 | 2020-02-25 |
| 1750913356 | Liza R Collins | Massage Therapist | 1415 State Wi 16, La Crosse, WI 54601 | 2020-02-11 |
| Find all providers in zip 54601 | ||||
| Taxonomy Code | 261QR0207X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Radiology, Mobile Mammography |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598323073 | Wisconsin Mobile Imaging Inc. | Clinic/Center | 234 W Florida St Ste 209, Milwaukee, WI 53204-1659 | 2019-05-30 |
| 1992954861 | Livito LLC | Clinic/Center | 5028 46th Ave, Kenosha, WI 53144-2025 | 2008-09-15 |
| 1740600600 | Bellin Memorial Hospital Inc | Clinic/Center | 744 S Webster Ave, Green Bay, WI 54301-3505 | 2014-04-18 |
| 1821304098 | Marshfield Clinic Inc. | Clinic/Center | 1000 N Oak Ave, Marshfield, WI 54449-5703 | 2010-08-26 |
| 1538321872 | Aspirus Clinics Inc | Clinic/Center | 333 Pine Ridge Blvd, Wausau, WI 54401-4120 | 2008-06-27 |
| 1891740585 | Bellin Memorial Hospital Inc. | Clinic/Center | 744 S Webster Ave, Green Bay, WI 54301-3505 | 2006-05-23 |
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| 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.