Individual provider Active NPI

Kendra L White, MSN, APNP, FNP-C

  • Family Nurse Practitioner
  • Green Bay, WI
National Provider Identifier
1083377386
Registry record updated Jul 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11439-33 Issued in WI
Practice address
725 S Webster Ave Ste 303
Green Bay, WI 54301-3539
Phone
(920) 431-5650
Fax
(920) 433-7400
NPI assigned
Oct 14, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2024

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 11439 WI
Family Nurse Practitioner 363LF0000X 11439-33 WI Primary

Addresses

Primary practice location

725 S Webster Ave Ste 303
Green Bay, WI 54301-3539

Mailing address

744 S Webster Ave
Medical Staff Services
Green Bay, WI 54301

Other identifiers 1

IdentifierTypeStateIssuer
100194212MedicaidWI

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address kwhite58853@direct.myadvocateaurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

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
I20220224002064 WI Practitioner - Nurse Practitioner 7214321827 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Bellin Memorial Hospital IncGroup PAC ID 8820900749, 685 clinicians

Practice addresses (Care Compare)

725 S Webster Ave
Suite 303
Green Bay, WI 54301-3539
Phone (920) 431-5650

Hospital & facility affiliations

  • Bellin Memorial Hospital Hospital, Green Bay, WI, CCN 520049

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
11439WIMDNurse Practitioner
11439-33WIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Oconto Hospital & Medical Center Inc Current Accepting new patients
Oconto Hospital & Medical Center Inc CurrentSince May 15, 2024 Accepting new patients
Bellin Memorial Hospital Inc Current Accepting new patients
Bellin Memorial Hospital Inc CurrentSince May 15, 2024 Accepting new patients
Bellin Memorial Hospital Inc Past Accepting new patients

Locations

933 Waube Ln
Green Bay, WI 54304
Phone (920) 548-9500

744 S Webster Ave
Green Bay, WI 54301
Phone (920) 433-6025

2845 Greenbrier Rd
Green Bay, WI 54311
Phone (920) 288-3388

725 S Webster Ave
Ste 303
Green Bay, WI 54301
Phone (920) 431-5650

3415 Custer St
Ste D
Manitowoc, WI 54220
Phone (920) 652-9310

2820 Roosevelt Rd
Marinette, WI 54143
Phone (715) 330-6171

820 Arbutus Ave
Oconto, WI 54153
Phone (920) 835-1100

Interoperability endpoints

  • Direct secure messaging: kwhite58853@direct.myadvocateaurora.org
  • Direct secure messaging: kwhite339674@direct.thedacare.org
  • Direct secure messaging: kwhite924510@direct.emplifyhealth.org

Organizations & group practices 5

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": "1634169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722384000000",
    "number": "1083377386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "744 S WEBSTER AVE",
            "address_2": "MEDICAL STAFF SERVICES",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "54301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 S WEBSTER AVE STE 303",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543013539",
            "telephone_number": "920-431-5650",
            "fax_number": "920-433-7400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITE",
        "first_name": "KENDRA",
        "middle_name": "L",
        "credential": "MSN, APNP, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-14",
        "last_updated": "2024-07-31",
        "certification_date": "2024-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "11439",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "11439-33",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100194212",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kwhite58853@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2845 Greenbrier Rd",
            "city": "Green Bay",
            "state": "WI",
            "country_code": "US",
            "postal_code": "543116519",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "2845 Greenbrier Rd",
            "city": "Green Bay",
            "state": "WI",
            "country_code": "US",
            "postal_code": "543116519",
            "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.