Individual provider Active NPI

McKenna Rickman, NP

  • Nurse Practitioner
  • Marshfield, WI
National Provider Identifier
1114409406
Registry record updated Aug 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
13201 Issued in WI
Practice address
203 W Upham St
Marshfield, WI 54449-1460
Phone
(715) 305-2214
NPI assigned
Sep 3, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 236016 WI
Nurse Practitioner 363L00000X 13201 WI Primary

Addresses

Primary practice location

203 W Upham St
Marshfield, WI 54449-1460

Mailing address

203 W Upham St
Marshfield, WI 54449-1460

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
I20221101003161 WI Practitioner - Nurse Practitioner 5395112551 Reassigns benefits to 9 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
80.58 of 100Reported as group
Quality
55.5
Promoting interoperability
100
Improvement activities
40
Cost
71.46

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
13201WIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Hospital Inc CurrentSince Nov 14, 2022 Accepting new patients
MCHS Hospitals Inc CurrentSince Nov 14, 2022 Accepting new patients
Flambeau Hospital Inc CurrentSince Nov 14, 2022 Accepting new patients
MCHS Hospitals Inc Current Accepting new patients
Beaver Dam Community Hospitals Inc CurrentSince Nov 14, 2022 Accepting new patients
Lakeview Medical Center Inc of Rice Lake CurrentSince Nov 14, 2022 Accepting new patients
Flambeau Hospital Inc CurrentSince Nov 14, 2022 Accepting new patients
Marshfield Clinic Inc CurrentSince Nov 14, 2022 Accepting new patients
MCHS Hospitals Inc CurrentSince Nov 14, 2022 Accepting new patients
MCHS Hospitals Inc Current Accepting new patients
Beaver Dam Community Hospitals Inc CurrentSince Nov 14, 2022 Accepting new patients

Locations

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

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

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

1102 S Center Ave
Merrill, WI 54452
Phone (715) 536-3399

N3708 River Ave
Neillsville, WI 54456
Phone (715) 743-3101

1700 W Stout St
Rice Lake, WI 54868
Phone (715) 236-6133

Organizations & group practices 11

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": "1535932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723766400000",
    "number": "1114409406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "203 W UPHAM ST",
            "city": "MARSHFIELD",
            "state": "WI",
            "postal_code": "544491460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 W UPHAM ST",
            "city": "MARSHFIELD",
            "state": "WI",
            "postal_code": "544491460",
            "telephone_number": "715-305-2214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICKMAN",
        "first_name": "MCKENNA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-03",
        "last_updated": "2024-08-16",
        "certification_date": "2024-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WI",
            "license": "236016",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "13201",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marshfield, WI

Sources for this page

Verify at the official NPI Registry.