Individual provider Active NPI

Alicia Sund

  • Nurse Practitioner
  • Baldwin, WI
National Provider Identifier
1114763786
Registry record updated Aug 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
15636 Issued in WI
Practice address
1100 Bergslien St
Baldwin, WI 54002-2600
Phone
(715) 684-1111
Fax
(715) 684-1111
NPI assigned
Jul 3, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 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 15636 WI Primary
Registered Nurse 163W00000X 242814-30 WI

Addresses

Primary practice location

1100 Bergslien St
Baldwin, WI 54002-2600

Mailing address

1100 Bergslien St
Baldwin, WI 54002-2600
Phone (715) 684-1111

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
I20241004001954 WI Practitioner - Nurse Practitioner 6709317464 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Baldwin Area Medical Center IncGroup PAC ID 7911800586, 88 clinicians

Practice addresses (Care Compare)

1100 Bergslien St
Baldwin, WI 54002-2600
Phone (715) 684-1555

Hospital & facility affiliations

  • Western Wisconsin Health Hospital, Baldwin, WI, CCN 521347
  • River Falls Area Hospital Hospital, River Falls, WI, CCN 521349

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
242814-30WIMDRegistered Nurse
15636WIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Baldwin Area Medical Center Inc. CurrentSince Oct 1, 2024 Accepting new patients
Baldwin Area Medical Center, Inc. CurrentSince Oct 1, 2024 Accepting new patients

Locations

1100 Bergslien St
Baldwin, WI 54002
Phone (715) 684-1111

503 Cherry Ln
Roberts, WI 54023
Phone (715) 684-1111

Interoperability endpoints

  • Direct secure messaging: asund325246@excellian.direct.allina.com

Organizations & group practices 2

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 5

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": "1719964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722556800000",
    "number": "1114763786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 BERGSLIEN ST",
            "city": "BALDWIN",
            "state": "WI",
            "postal_code": "540022600",
            "telephone_number": "715-684-1111",
            "fax_number": "715-684-1111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 BERGSLIEN ST",
            "city": "BALDWIN",
            "state": "WI",
            "postal_code": "540022600",
            "telephone_number": "715-684-1111",
            "fax_number": "715-684-1111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUND",
        "first_name": "ALICIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-03",
        "last_updated": "2024-08-02",
        "certification_date": "2024-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "15636",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WI",
            "license": "242814-30",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baldwin, WI

Sources for this page

Verify at the official NPI Registry.