Individual provider Active NPI

Cassandra Kneifl, DNP, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Oconomowoc, WI
National Provider Identifier
1043783590
Registry record updated Jun 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
8963 Issued in WI
Practice address
1205 Corporate Center Dr
Oconomowoc, WI 53066-4898
Phone
(262) 303-2131
NPI assigned
Jan 8, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 8963 WI Primary

Addresses

Primary practice location

1205 Corporate Center Dr
Oconomowoc, WI 53066-4898

Mailing address

1205 Corporate Center Dr
Oconomowoc, WI 53066-4898
Phone (262) 303-2131

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
I20190328000626 WI Practitioner - Nurse Practitioner 0941540041 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8963WIMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Rogers Memorial Hospital Incorporated CurrentSince Apr 1, 2019 Accepting new patients

Locations

5 Innovation Ct
Ste 100
Appleton, WI 54914

34700 Valley Rd
Oconomowoc, WI 53066

1230 Corporate Center Dr
Ste 400
Oconomowoc, WI 53066
Phone (262) 560-1527

1205 Corporate Center Dr
Oconomowoc, WI 53066
Phone (262) 567-4828

11101 W Lincoln Ave
West Allis, WI 53227
Phone (414) 203-4500

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1546905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560988800000",
    "number": "1043783590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1205 CORPORATE CENTER DR",
            "city": "OCONOMOWOC",
            "state": "WI",
            "postal_code": "530664898",
            "telephone_number": "262-303-2131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1205 CORPORATE CENTER DR",
            "city": "OCONOMOWOC",
            "state": "WI",
            "postal_code": "530664898",
            "telephone_number": "262-303-2131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNEIFL",
        "first_name": "CASSANDRA",
        "name_prefix": "Dr.",
        "credential": "DNP, PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-08",
        "last_updated": "2019-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WI",
            "license": "8963",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oconomowoc, WI

Sources for this page

Verify at the official NPI Registry.