NPIMap

Individual provider Active NPI

Kristine M Grow, APNP

  • Family Nurse Practitioner
  • Fond Du Lac, WI
National Provider Identifier
1093392565
Registry record updated Dec 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
10808 Issued in WI
Practice address
420 E Division St
Fond Du Lac, WI 54935-4560
Phone
(920) 926-7400
NPI assigned
Mar 29, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 10808 WI Primary

Addresses

Primary practice location

420 E Division St
Fond Du Lac, WI 54935-4560

Mailing address

420 E Division St
Fond Du Lac, WI 54935-4560
Phone (920) 926-7400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210526000369 WI Practitioner - Nurse Practitioner 1850790734 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
Agnesian Healthcare IncGroup PAC ID 1658289624, 392 clinicians

Practice addresses (Care Compare)

360 S Mountin Dr
Mayville, WI 53050-1498
Phone (920) 387-2111

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Marshfield Clinic Inc CurrentSince Jul 25, 2023 Accepting new patients
Beaver Dam Community Hospitals Inc CurrentSince Jun 28, 2021 Accepting new patients
MCHS Hospitals Inc CurrentSince Jul 25, 2023 Accepting new patients
MCHS Hospitals Inc CurrentSince Jul 25, 2023 Accepting new patients
Agnesian Healthcare Inc CurrentSince Oct 26, 2023 Accepting new patients
Agnesian Healthcare Inc CurrentSince Oct 26, 2023 Accepting new patients
Agnesian Healthcare, Inc Current Accepting new patients
MCHS Hospitals Inc Current Accepting new patients
Beaver Dam Community Hospitals Inc CurrentSince Jun 28, 2021 Accepting new patients

Locations

705 S University Ave
Beaver Dam, WI 53916
Phone (920) 885-6090

707 S University Ave
Beaver Dam, WI 53916
Phone (920) 887-4006

3501 Golf Rd
Eau Claire, WI 54701
Phone (715) 858-4200

420 E Division St
Fond du Lac, WI 54935
Phone (920) 923-7400

1808 W Beltline Hwy
Madison, WI 53713
Phone (608) 250-1497

1000 N Oak Ave
Marshfield, WI 54449
Phone (715) 387-5111

360 S Mountin Dr
Mayville, WI 53050
Phone (920) 387-2111

Interoperability endpoints

  • Direct secure messaging: kristine.grow@marshfieldclinichealthsystem.cernerdirect.com
  • Direct secure messaging: kgrow496908@direct-ehr-ssmhc.com

Organizations & group practices 9

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 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": "1616976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701820800000",
    "number": "1093392565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 E DIVISION ST",
            "city": "FOND DU LAC",
            "state": "WI",
            "postal_code": "549354560",
            "telephone_number": "920-926-7400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 E DIVISION ST",
            "city": "FOND DU LAC",
            "state": "WI",
            "postal_code": "549354560",
            "telephone_number": "920-926-7400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROW",
        "first_name": "KRISTINE",
        "middle_name": "M",
        "credential": "APNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-29",
        "last_updated": "2023-12-06",
        "certification_date": "2023-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "10808",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fond Du Lac, WI

Sources for this page

Verify at the official NPI Registry.