Individual provider Active NPI

Amanda Jo Carlson, DNP, FNP-BC

  • Nurse Practitioner
  • Greenfield, WI
National Provider Identifier
1114597168
Registry record updated Jul 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
11274-033 Issued in WI
Practice address
4448 W Loomis Rd
Greenfield, WI 53220-4800
Phone
(414) 281-5150
NPI assigned
Jun 30, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2026

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 11274-033 WI Primary
Family Nurse Practitioner 363LF0000X 2019053373 WI

Addresses

Primary practice location

4448 W Loomis Rd
Greenfield, WI 53220-4800

Mailing address

PO Box 735044
Chicago, IL 60673-5044
Phone (800) 326-2250

Other practice location 1

550 W Frontage Rd
Northfield, IL 60093-1202
Phone (847) 386-7744

Other identifiers 1

IdentifierTypeStateIssuer
100182065MedicaidWI

Other names 1

  • Amanda Jo Carlson-Dondero Former name

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address acarlsondondero385855@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
I20211005002570 WI Practitioner - Nurse Practitioner 3375941362 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Wisconsin School of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lakeshore Medical Clinic LLCGroup PAC ID 7719890730, 375 clinicians

Practice addresses (Care Compare)

4448 W Loomis Rd
Greenfield, WI 53220-4800
Phone (414) 281-5150

Hospital & facility affiliations

  • Aurora St Lukes Medical Center Hospital, Milwaukee, WI, CCN 520138
  • West Allis Memorial Hospital Hospital, West Allis, WI, CCN 520139

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11274-033WIMDNurse Practitioner
2019053373WIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeshore Medical Clinic, LLC CurrentSince Nov 21, 2023 Accepting new patients
Telemedico Physicians SC PastSince Jul 1, 2021 Accepting new patients
Telemedico Physicians Pulmonary SC PastSince Jul 1, 2021 Accepting new patients

Locations

4448 W Loomis Rd
Milwaukee, WI 53220
Phone (414) 281-5150

4500 W Loomis Rd
Milwaukee, WI 53220
Phone (414) 325-5300

S74W16775 Janesville Rd
Muskego, WI 53150
Phone (414) 422-4747

2000 E Layton Ave
St Francis, WI 53235
Phone (414) 744-7880

Interoperability endpoints

  • Direct secure messaging: ms_acarls29@landmarkhealth-direct.org
  • Direct secure messaging: acarlsondondero385855@direct.myadvocateaurora.org

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 and National Provider Directory roles.

Hospital & facility affiliations 4

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": "1625011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782950400000",
    "number": "1114597168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 735044",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606735044",
            "telephone_number": "800-326-2250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4448 W LOOMIS RD",
            "city": "GREENFIELD",
            "state": "WI",
            "postal_code": "532204800",
            "telephone_number": "414-281-5150"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "550 W Frontage Rd",
            "address_purpose": "LOCATION",
            "city": "Northfield",
            "state": "IL",
            "postal_code": "600931202",
            "country_code": "US",
            "telephone_number": "847-386-7744",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARLSON",
        "first_name": "AMANDA",
        "middle_name": "JO",
        "credential": "DNP, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-30",
        "last_updated": "2026-07-02",
        "certification_date": "2026-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "11274-033",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "2019053373",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100182065",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "acarlsondondero385855@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "4448 W Loomis Rd",
            "city": "Greenfield",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532204800",
            "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": "4448 W Loomis Rd",
            "city": "Greenfield",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532204800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "CARLSON-DONDERO",
            "middle_name": "JO",
            "credential": "DNP, FNP-BC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Greenfield, WI

Sources for this page

Verify at the official NPI Registry.