Individual provider Active NPI

Conner Mickelson

  • Nurse Practitioner
  • Madison, WI
National Provider Identifier
1003704115
Registry record updated Oct 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
16932-33 Issued in WI
Practice address
600 Highland Ave
Madison, WI 53792-0001
Phone
(608) 266-1530
NPI assigned
Jun 26, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 16932-33 WI Primary
Acute Care Nurse Practitioner 363LA2100X 16932-33 WI

Addresses

Primary practice location

600 Highland Ave
Madison, WI 53792-0001

Mailing address

7974 Uw Health CT
Middleton, WI 53562-5531

Other practice location 1

8440 Market St Apt 223
Middleton, WI 53562-4778
Phone (608) 576-0618

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
I20251001001399 WI Practitioner - Nurse Practitioner 9234635079 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Wisconsin School of Medicine, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of Wisconsin Medical Foundation IncGroup PAC ID 6608785464, 2,537 clinicians

Practice addresses (Care Compare)

600 Highland Ave
Madison, WI 53792-0001
Phone (608) 263-6400

Hospital & facility affiliations

  • University of Wi Hospitals & Clinics Authority Hospital, Madison, WI, CCN 520098

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
16932-33WIMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University of Wisconsin Medical Foundation, Inc CurrentSince Oct 6, 2025 Accepting new patients
University of Wisconsin Medical Foundation, Inc CurrentSince Oct 6, 2025 Accepting new patients
University of Wisconsin Medical Foundation Inc Past Accepting new patients

Locations

600 Highland Ave
Madison, WI 53792
Phone (608) 263-0325

7974 Uw Health Ct
Middleton, WI 53562
Phone (608) 829-5270

Organizations & group practices 3

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 1

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": "1750896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759708800000",
    "number": "1003704115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7974 UW HEALTH CT",
            "city": "MIDDLETON",
            "state": "WI",
            "postal_code": "535625531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 HIGHLAND AVE",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537920001",
            "telephone_number": "608-266-1530"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8440 Market St Apt 223",
            "address_purpose": "LOCATION",
            "city": "Middleton",
            "state": "WI",
            "postal_code": "535624778",
            "country_code": "US",
            "telephone_number": "608-576-0618",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MICKELSON",
        "first_name": "CONNER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-06-26",
        "last_updated": "2025-10-06",
        "certification_date": "2025-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "16932-33",
            "primary": true
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "WI",
            "license": "16932-33",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

Verify at the official NPI Registry.