1. Home
  2. Directory
  3. Wisconsin
  4. Rhinelander
  5. Internal Medicine
  6. NPI Profile
  7. NPI Record 1508059809

WISCONSIN GASTROENTEROLOGY ASSOCIATES, LLC
Complete NPI Record 1508059809
Internal Medicine - Gastroenterology in Rhinelander, WI

NPI Status: Active since August 21, 2007

Contact Information

2251 N SHORE DR
RHINELANDER, WI
ZIP 54501
Phone: (906) 225-3880
Fax: (906) 225-4523

Get Directions

Table of Contents

  1. NPI
  2. Entity Type Code
  3. Employer Identification Number EIN
  4. Provider Organization Name Legal Business Name
  5. Provider First Line Business Mailing Address
  6. Provider Second Line Business Mailing Address
  7. Provider Business Mailing Address City Name
  8. Provider Business Mailing Address State Name
  9. Provider Business Mailing Address Postal Code
  10. Provider Business Mailing Address Country Code If outside U S
  11. Provider Business Mailing Address Telephone Number
  12. Provider Business Mailing Address Fax Number
  13. Provider First Line Business Practice Location Address
  14. Provider Business Practice Location Address City Name
  15. Provider Business Practice Location Address State Name
  16. Provider Business Practice Location Address Postal Code
  17. Provider Business Practice Location Address Country Code If outside U S
  18. Provider Business Practice Location Address Telephone Number
  19. Provider Business Practice Location Address Fax Number
  20. Provider Enumeration Date
  21. Last Update Date
  22. Authorized Official Last Name
  23. Authorized Official First Name
  24. Authorized Official Middle Name
  25. Authorized Official Title or Position
  26. Authorized Official Telephone Number
  27. Healthcare Provider Taxonomy Code 1
  28. Healthcare Provider Primary Taxonomy Switch 1
  29. Is Organization Subpart
  30. Parent Organization LBN
  31. Parent Organization TIN
  32. Authorized Official Name Prefix Text
  33. Authorized Official Credential Text
  34. Healthcare Provider Taxonomy Group 1

Complete NPI Dataset

This page represents the complete record for NPI 1508059809. You can access the complete dataset, including a full list of field names, along with their values, and definitions as recorded by the NPI registry. Each field in the NPI record is explained, highlighting its significance and the possible values it can hold.

NPI: 1508059809
The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
Entity Type Code: 2
Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Employer Identification Number EIN: UNAVAIL
The Employer Identification Number (EIN), assigned by the IRS, of the provider being identified.
The name of the organization provider. If the provider is an organization, this is the legal business name.
Provider First Line Business Mailing Address: 1414 W FAIR AVE
The name of the organization provider. If the provider is an organization, this is the legal business name.
Provider Second Line Business Mailing Address: STE. 250
The second line mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider second line location address’’.
Provider Business Mailing Address City Name: MARQUETTE
The second line mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider second line location address’’.
Provider Business Mailing Address State Name: MI
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address State name’’.
Provider Business Mailing Address Postal Code: 498552675
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address State name’’.
Provider Business Mailing Address Country Code If outside U S : US
The country code in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address country code’’.
Provider Business Mailing Address Telephone Number: 9062253880
The country code in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address country code’’.
Provider Business Mailing Address Fax Number: 9062254523
The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address fax number’’.
Provider First Line Business Practice Location Address: 2251 N SHORE DR
The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address fax number’’.
Provider Business Practice Location Address City Name: RHINELANDER
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State Name: WI
The city name in the location address of the provider being identified.
Provider Business Practice Location Address Postal Code: 545018360
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Country Code If outside U S : US
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Telephone Number: 9062253880
The telephone number associated with the location address of the provider being identified.
Provider Business Practice Location Address Fax Number: 9062254523
The fax number associated with the location address of the provider being identified.
Provider Enumeration Date: 8/21/2007
The date the provider was assigned a unique identifier (assigned an NPI).
Last Update Date: 2/11/2008
The date that a record was last updated or changed.
Authorized Official Last Name: KIM
The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
Authorized Official First Name: JOSEPH
The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with ‘‘provider taxonomy code’’.
Authorized Official Middle Name: PETER
The code representing the State that issued the license to the provider being identified. This field can accommodate multiple States. It is associated with ‘‘provider license number.
Authorized Official Title or Position: PRESIDENT OF SOLE MEMBER
Authorized Official Telephone Number: 9062253880
Code indicating whether the provider is operating as a sole proprietor. Codes are: Y = Yes; N = No
Healthcare Provider Taxonomy Code 1: 207RG0100X
Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
Healthcare Provider Primary Taxonomy Switch 1: Y
Is Organization Subpart: Y
Parent Organization LBN: U.P. DIGESTIVE DISEASE ASSOC., P.C.
Parent Organization TIN: UNAVAIL
Authorized Official Name Prefix Text: DR.
Authorized Official Credential Text: M.D.
Healthcare Provider Taxonomy Group 1: 193400000X SINGLE SPECIALTY GROUP