Individual provider Active NPI

Cathy Devalk-Holl, NP

  • Nurse Practitioner
  • Suamico, WI
National Provider Identifier
1083808471
Registry record updated Nov 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
3178 Issued in WI
Practice address
2890 Lineville Rd
Suamico, WI 54173
Phone
(920) 662-2100
NPI assigned
Aug 29, 2007
Last updated
Nov 30, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2021

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 3178 WI Primary

Addresses

Primary practice location

2890 Lineville Rd
Suamico, WI 54173

Mailing address

4783 N County P
New Franken, WI 54229
Phone (920) 866-9092

Electronic endpoints 2

TypeEndpointUseAffiliation
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/
Direct Messaging Address cdevalkholl57716@direct.myadvocateaurora.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
I20071015000442 WI Practitioner - Nurse Practitioner 3476649906 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3301 W Forest Home Ave
Milwaukee, WI 53215-2843

4783 N County Rd P
New Franken, WI 54229-9432

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Aurora Medical Group, Inc. CurrentSince Aug 21, 2007 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Aug 21, 2007 Accepting new patients
Aurora Medical Group, Inc. Past Accepting new patients

Locations

123 N Military Ave
Green Bay, WI 54303
Phone (920) 494-3421

2733 S Ridge Rd
Green Bay, WI 54304
Phone (920) 497-6200

2845 Greenbrier Rd
#1
Green Bay, WI 54311
Phone (920) 288-8100

1020 N 12th St
Milwaukee, WI 53233
Phone (414) 219-3056

108 S 10th Ave
Sturgeon Bay, WI 54235
Phone (920) 746-7955

2890 Lineville Rd
Suamico, WI 54313
Phone (920) 662-2100

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1188345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638230400000",
    "number": "1083808471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4783 N COUNTY P",
            "city": "NEW FRANKEN",
            "state": "WI",
            "postal_code": "54229",
            "telephone_number": "920-866-9092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2890 LINEVILLE RD",
            "city": "SUAMICO",
            "state": "WI",
            "postal_code": "54173",
            "telephone_number": "920-662-2100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEVALK-HOLL",
        "first_name": "CATHY",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-29",
        "last_updated": "2021-11-30",
        "certification_date": "2021-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "3178",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "2890 Lineville Rd",
            "city": "Suamico",
            "state": "WI",
            "country_code": "US",
            "postal_code": "54173",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cdevalkholl57716@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2890 Lineville Rd",
            "city": "Suamico",
            "state": "WI",
            "country_code": "US",
            "postal_code": "54173",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Suamico, WI

Sources for this page

Verify at the official NPI Registry.