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PREMISE HEALTH OF WISCONSIN MEDICAL SC
NPI 1912690439
Clinic/Center - Multi-Specialty in Windsor, WI

Active since May 31, 2023CLIA 52D2166605 · Waiver
6091 PEPSI WAY, WINDSOR, WI 53598(608) 338-0400(608) 824-8817 Get Directions Write a Review

NPPES record last updated: February 5, 2026. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Feb 5, 2026, Aug 15, 2025, May 31, 2023 (3 updates tracked since 2023).

About Premise Health Of Wisconsin Medical Sc NPPES

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

PREMISE HEALTH OF WISCONSIN MEDICAL SC (NPI 1912690439), doing business as Kwik Trip Center For Health, Deforest, is a healthcare organization registered as a multi-specialty in Windsor, Wisconsin and active in the NPI registry since May 2023. The organization holds a CLIA Waiver certificate valid through May 20, 2027 and lists Edward William Schwartz, President, as its authorized official.

NPPES Registry Identity

NPI1912690439
Entity TypeOrganization
Primary Taxonomy261QM1300X
Legal Business NamePREMISE HEALTH OF WISCONSIN MEDICAL SC
Location Address6091 PEPSI WAYWindsor, WI 53598
Mailing Address5500 Maryland Way Ste 120Brentwood, TN 37027-4993
Phone(608) 338-0400
Fax(608) 824-8817
Organization SubpartNo
Authorized OfficialEdward William SchwartzPresident · (844) 407-7557
Enumeration DateMay 31, 2023
Last NPPES UpdateFebruary 5, 20263 updates tracked since enumeration
NPPES CertifiedFebruary 5, 2026
✔ NPI 1912690439 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Multi-SpecialtyAmbulatory Health Care Facilities
Taxonomy Code261QM1300X
6091 PEPSI WAY, Windsor, WI 53598
Open in Google Maps ↗

Other Names 1

Doing Business AsKwik Trip Center For Health, Deforest

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 52D2166605

Premise Health Of Wisconsin Medical, Sc · Windsor, WI
Active · expires May 20, 2027
CLIA Number52D2166605
Laboratory TypePhysician Office
Certificate Effective DateMay 21, 2025
Certificate Expiration DateMay 20, 2027
Laboratory DirectorDr. Erik Gundersen
Laboratory Phone(608) 338-0400
Laboratory LocationPremise Health Of Wisconsin Medical, Sc6091 Pepsi Way, Windsor, WI 53598
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 Premise Health Of Wisconsin Medical Sc's NPI number?

The NPI number for Premise Health Of Wisconsin Medical Sc is 1912690439. It was assigned to this organization in the NPPES registry on May 31, 2023. The provider is doing business as Kwik Trip Center for Health, DeForest.

Where is Premise Health Of Wisconsin Medical Sc located?

Premise Health Of Wisconsin Medical Sc is located at 6091 Pepsi Way, Windsor, WI 53598. The listed phone number is (608) 338-0400.

What is Premise Health Of Wisconsin Medical Sc's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Multi-Specialty, with taxonomy code 261QM1300X.

Does Premise Health Of Wisconsin Medical Sc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 52D2166605) is associated with this NPI, valid through May 20, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Premise Health Of Wisconsin Medical Sc was last updated on February 5, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.