Individual provider Active NPI

Katie Peper, NP

  • Family Nurse Practitioner
  • Baraboo, WI
National Provider Identifier
1003463365
Registry record updated Feb 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
9383-33 Issued in WI
Practice address
S2845 White Eagle Rd
Baraboo, WI 53913-9064
Phone
(608) 355-1240
Fax
(608) 355-5166
NPI assigned
Aug 21, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 9383-33 WI Primary

Addresses

Primary practice location

S2845 White Eagle Rd
Baraboo, WI 53913-9064

Mailing address

E5139 Hillcrest Dr
Loganville, WI 53943-9719

Other identifiers 2

IdentifierTypeStateIssuer
100095623MedicaidWI
NAOtherI DO NOT HAVE A NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191216001393 WI Practitioner - Nurse Practitioner 0143654640 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ho Chunk NationGroup PAC ID 5496709867, 30 clinicians

Practice addresses (Care Compare)

S2845 White Eagle Rd
Baraboo, WI 53913-9064
Phone (608) 355-1240

Hospital & facility affiliations

  • Marshfield Medical Center Hospital, Marshfield, WI, CCN 520037
  • SSM Health St Clare Hospital - Baraboo Hospital, Baraboo, WI, CCN 520057

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ho Chunk Nation CurrentSince Jan 2, 2020 Accepting new patients
Ho-Chunk Nation CurrentSince Jan 2, 2020 Accepting new patients

Locations

S2845 White Eagle Rd
Baraboo, WI 53913
Phone (608) 355-1240

N6520 Lumberjack Guy Rd
Blk River Fls, WI 54615
Phone (715) 284-9851

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1566345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643673600000",
    "number": "1003463365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "E5139 HILLCREST DR",
            "city": "LOGANVILLE",
            "state": "WI",
            "postal_code": "539439719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "S2845 WHITE EAGLE RD",
            "city": "BARABOO",
            "state": "WI",
            "postal_code": "539139064",
            "telephone_number": "608-355-1240",
            "fax_number": "608-355-5166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEPER",
        "first_name": "KATIE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-21",
        "last_updated": "2022-02-01",
        "certification_date": "2022-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "9383-33",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100095623",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "I DO NOT HAVE A NUMBER",
            "identifier": "NA",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baraboo, WI

Sources for this page

Verify at the official NPI Registry.