WAUSAU AVIATION MEDICINE SERVICES - NPI 1356486369

Q: What is Wausau Aviation Medicine Services's NPI number?

The NPI number for Wausau Aviation Medicine Services is 1356486369. It was assigned to this organization in the NPPES registry on February 20, 2007.

Q: What is Wausau Aviation Medicine Services's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

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About Wausau Aviation Medicine Services NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

WAUSAU AVIATION MEDICINE SERVICES (NPI 1356486369) is a healthcare organization registered as a family medicine in Wausau, Wisconsin and active in the NPI registry since February 2007. The organization holds a CLIA Waiver certificate valid through December 26, 2026 and lists Glenn Brigham Burt, Owner, as its authorized official.

NPPES Registry Identity

NPI1356486369

Entity TypeOrganization

Primary Taxonomy207Q00000X

Legal Business NameWAUSAU AVIATION MEDICINE SERVICES

Location Address915 WOODS PLACEWausau, WI 54403-7074

Mailing AddressPo Box 477Wausau, WI 54402-0477 · (715) 675-5371 · Fax (715) 675-5381

Phone(715) 675-5371

Fax(715) 675-5381

Organization SubpartNo

Authorized OfficialGlenn Brigham BurtOwner · (715) 675-5371

Enumeration DateFebruary 20, 2007

Last NPPES UpdateMarch 15, 2016

✔ NPI 1356486369 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in WI · 27936

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

915 WOODS PLACE, Wausau, WI 54403

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Other Identifiers 4

Medicare UPINF35540WI

Medicaid21286900WI

Other201533595018WI · Anthem Bcbs

Medicare ID-Type Unspecified000039264WI · Provider Number

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 52D1035239

Wausau Aviation Medicine Services · Wausau, WI

Active · expires Dec 26, 2026

CLIA Number52D1035239

Laboratory TypePhysician Office

Certificate Effective DateDecember 27, 2024

Certificate Expiration DateDecember 26, 2026

Laboratory DirectorDr. Glenn B. Burt III

Laboratory Phone(715) 675-5371

Laboratory LocationWausau Aviation Medicine Services915 Woods Place, Wausau, WI 54403

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Wausau Aviation Medicine Services's NPI number?

The NPI number for Wausau Aviation Medicine Services is 1356486369. It was assigned to this organization in the NPPES registry on February 20, 2007.

Where is Wausau Aviation Medicine Services located?

Wausau Aviation Medicine Services is located at 915 Woods Place, Wausau, WI 54403. The listed phone number is (715) 675-5371.

What is Wausau Aviation Medicine Services's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Does Wausau Aviation Medicine Services hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 52D1035239) is associated with this NPI, valid through December 26, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Wausau Aviation Medicine Services was last updated on March 15, 2016. NPI Profile syncs with the weekly NPPES data releases published by CMS.