GUNDERSEN CLINIC, LTD. – NPI #1053366518
Clinic/Center

A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).

GUNDERSEN CLINIC, LTD. is an AHC clinic located in FAYETTE, IA. NPPES has assigned the NPI number 1053366518 to GUNDERSEN CLINIC, LTD. on May 23, 2006. It is a Type-2 NPI, indicating this NPI number is associated with an organization. GUNDERSEN CLINIC, LTD. is also known by the name GL FAYETTE CLINIC. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 261Q00000X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center.

The NPI profile was previously updated about 10 years ago on Mar 07, 2016. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for GUNDERSEN CLINIC, LTD. below.

NPI Profile for
GUNDERSEN CLINIC, LTD.

NPI Number
1053366518
Enumeration Date

(more than 20 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
GUNDERSEN CLINIC, LTD.
Other Name: GL FAYETTE CLINIC
Primary location
110 KING STREET
FAYETTE, IA 52142
Phone: (608) 782-7300 Fax:
Mailing address
1836 SOUTH AVE
LA CROSSE, WI 54601-5429
Phone: (608) 782-7300 Fax:
Organization Subpart
Yes - GUNDERSEN CLINIC, LTD. is subpart of another organization.
Authorized Official
KARI ADANK
CCO
Phone: (608) 775-8025
Updated
Identifiers

Identifiers for GUNDERSEN CLINIC, LTD.

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
MEDICAIDIA0638189
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261Q00000X
- Clinic/Center (Primary)
332B00000X
- Durable Medical Equipment & Medical Supplies
261QR1300X
- Clinic/Center / Rural Health

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.