Individual provider Active NPI

Serena Ashour, APNP

  • Nurse Practitioner
  • Green Bay, WI
National Provider Identifier
1023623832
Registry record updated Oct 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
F06202253 Issued in WI
Practice address
1821 S Webster Ave
Green Bay, WI 54301-2253
Phone
(920) 496-4700
NPI assigned
Sep 9, 2020
Last updated
Oct 28, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X F06202253 WI Primary

Addresses

Primary practice location

1821 S Webster Ave
Green Bay, WI 54301-2253

Mailing address

PO Box 19070
Green Bay, WI 54307-9070
Phone (920) 496-4700

Other practice location 1

2502 S Ashland Ave
Green Bay, WI 54304
Phone (920) 496-4700

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address sashour38279@ewd.direct.hshs.org Direct

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
I20210226000895 WI Practitioner - Nurse Practitioner 7012322951 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2502 S Ashland Ave
Green Bay, WI 54304-5252
Phone (920) 496-4700

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F06202253WIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St Vincent Hospital-Hospital Sisters-Third Order of St Francis CurrentSince Jan 1, 2022 Accepting new patients
St. Nicholas Hospital-Sisters of the Third Order of St Francis Current Accepting new patients
St Nicholas Hospital-Sisters of the Third Order of St Francis Nurse Practitioner CurrentSince Jan 1, 2022 Accepting new patients
St Vincent Hospital-Hospital Sisters-Third Order of St Francis CurrentSince Jan 1, 2022 Accepting new patients
Prevea Clinic, Inc. Current Accepting new patients
Froedtert Manitowoc Medical Group, LLC CurrentSince Apr 2, 2022 Accepting new patients
St Nicholas Hospital-Sisters of the Third Order of St Francis CurrentSince Jan 1, 2022 Accepting new patients
Prevea Clinic, Inc. CurrentSince Jan 1, 2022 Accepting new patients

Locations

1726 Shawano Ave
Green Bay, WI 54303
Phone (920) 432-6016

1821 S Webster Ave
Green Bay, WI 54301
Phone (920) 431-1850

2502 S Ashland Ave
Green Bay, WI 54304
Phone (920) 496-4750

835 S Van Buren St
Green Bay, WI 54301
Phone (888) 901-7246

1650 S 41st St
Manitowoc, WI 54220
Phone (920) 320-3100

2300 Western Ave
Manitowoc, WI 54220
Phone (920) 320-2011

1414 N Taylor Dr
Sheboygan, WI 53081
Phone (920) 320-2011

3100 Superior Ave
Sheboygan, WI 53081
Phone (800) 472-6710

800 Lakefront Way
Two Rivers, WI 54241
Phone (920) 320-2011

Interoperability endpoints

  • Direct secure messaging: sashour38279@ewd.direct.hshs.org

Organizations & group practices 8

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

Hospital & facility affiliations 6

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": "1599609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666915200000",
    "number": "1023623832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19070",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543079070",
            "telephone_number": "920-496-4700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1821 S WEBSTER AVE",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543012253",
            "telephone_number": "920-496-4700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2502 S Ashland Ave",
            "address_purpose": "LOCATION",
            "city": "Green Bay",
            "state": "WI",
            "postal_code": "54304",
            "country_code": "US",
            "telephone_number": "920-496-4700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ASHOUR",
        "first_name": "SERENA",
        "credential": "APNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-09",
        "last_updated": "2022-10-28",
        "certification_date": "2022-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "F06202253",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sashour38279@ewd.direct.hshs.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "2502 S Ashland Ave",
            "city": "Green Bay",
            "state": "WI",
            "country_code": "US",
            "postal_code": "54304",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Green Bay, WI

Sources for this page

Verify at the official NPI Registry.