Kristin G Anderson, RN,APNP
Individual provider Active NPI Nurse Practitioner · Appleton, WI
NPI 1124454830 · NPPES record last updated Feb 19, 2021
Key facts
- NPI
- 1124454830
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- 5567-33 (WI)
- Practice address
- 1501 S Madison St
Appleton, WI 54915 - Phone
- (920) 738-2000
- NPI assigned
- Sep 26, 2013
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 6
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20140102000365 | WI | Practitioner - Nurse Practitioner | 2961630694 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 159374-30 | WI | MD | Registered Nurse |
| 5567-33 | WI | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bellin Memorial Hospital Inc | Current | Accepting new patients | |
| Ascension NE Wisconsin, Inc | Current |
Accepting new patients | |
| Bellin Memorial Hospital Inc | Current |
Accepting new patients | |
| Bellin Memorial Hospital Inc | Current |
Accepting new patients | |
| Ascension NE Wisconsin, Inc | Current |
Accepting new patients |
Locations
1506 S Oneida St
Appleton, WI 54915
Phone (920) 730-4950
835 S Van Buren St
Green Bay, WI 54301
Phone (888) 901-7246
1976 Lime Kiln Rd
Green Bay, WI 54311
Phone (920) 406-9865
744 S Webster Ave
Green Bay, WI 54301
Phone (920) 433-6025
2020 Riverside Dr
Ste 200
Green Bay, WI 54301
Phone (920) 433-9920
101 Main St
Neenah, WI 54956
Phone (920) 727-4200
Interoperability endpoints
- kristin.anderson.1@10114.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 5567-33 | WI | Yes |
| Registered Nurse | 163W00000X | 159374-30 | WI |
Addresses
Primary practice location
1501 S Madison St
Appleton, WI 54915
Mailing address
1501 S Madison St
Appleton, WI 54915-1846
Phone (920) 738-2000
Other practice location 1
2020 Riverside Dr
Green Bay, WI 54301-2300
Phone (920) 433-9920
Other practice location 2
2020 Riverside Dr
Green Bay, WI 54301-2300
Phone (920) 433-9920
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | kristin.anderson.1@10114.direct.athenahealth.com |
Other providers in Appleton, WI
- David M Anderson
- Heather Joi Anderson
- Jack Anderson
- Jennifer Ashley Anderson
- Jill A Anderson
- Michael Floyd Anderson
- William A Anderson
- Joshua Paul Andreini
- Brandi Andrews
- Shannon Andrews
All providers in Appleton, WI · Nurse Practitioner in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 19, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.