Individual provider Active NPI

Pamela D. Powell, APNP

  • Nurse Practitioner
  • Mequon, WI
National Provider Identifier
1134463862
Registry record updated Jul 1, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
5158 Issued in WI
Practice address
6425 W Mequon Rd
Mequon, WI 53092-1855
Phone
(262) 242-0051
NPI assigned
Nov 19, 2012
Last updated
Jul 1, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 5158 WI Primary

Addresses

Primary practice location

6425 W Mequon Rd
Mequon, WI 53092-1855

Mailing address

3003 W Good Hope Rd
Milwaukee, WI 53209-2042
Phone (414) 352-3100

Other names 1

  • Pamela D. Sampe Former name

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
I20130102000165 WI Practitioner - Nurse Practitioner 9133372006 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prohealth Medical Group IncGroup PAC ID 3476465188, 475 clinicians

Practice addresses (Care Compare)

1011 Spring City Dr
Suite 250
Waukesha, WI 53186-5934
Phone (262) 928-0370

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Prohealth Medical Group Inc. CurrentSince Feb 1, 2023 Accepting new patients
Interpedia, S.C. CurrentSince Dec 24, 2016 Accepting new patients
Affiliated Surgery Center Inc Past Accepting new patients
Watertown Physician Practices LLC Nurse Practitioner Past Accepting new patients
Anewu LLC PastSince Apr 9, 2019 Accepting new patients

Locations

195 Discovery Dr
Brookfield, WI 53045
Phone (262) 513-7100

195 Discovery Dr
Fl 2
Brookfield, WI 53045

1238 S Cesar E Chavez Dr
Milwaukee, WI 53204
Phone (414) 645-6665

945 N 12th St
Milwaukee, WI 53233
Phone (414) 219-5800

240 Maple Ave
Mukwonago, WI 53149
Phone (262) 928-1900

13900 W National Ave
New Berlin, WI 53151
Phone (262) 928-4500

1185 Corporate Center Dr
Ste 150
Oconomowoc, WI 53066
Phone (262) 928-5000

N57W24950 N Corporate Cir
Sussex, WI 53089
Phone (262) 544-4411

136 N Main St
Thiensville, WI 53092
Phone (262) 241-5414

216 Green Bay Rd
Ste 109
Thiensville, WI 53092
Phone (262) 241-5414

808 Cornerstone Xing
Waterford, WI 53185
Phone (262) 514-0120

109 Air Park Dr
Watertown, WI 53094
Phone (262) 928-5100

1011 Spring City Dr
Waukesha, WI 53186
Phone (262) 925-0370

1011 Spring City Dr
Ste 250
Waukesha, WI 53186
Phone (262) 928-0370

721 American Ave
Ste 310
Waukesha, WI 53188
Phone (262) 928-4880

N17W24100 Riverwood Dr
Waukesha, WI 53188
Phone (262) 820-3093

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1353283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435708800000",
    "number": "1134463862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3003 W GOOD HOPE RD",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532092042",
            "telephone_number": "414-352-3100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6425 W MEQUON RD",
            "city": "MEQUON",
            "state": "WI",
            "postal_code": "530921855",
            "telephone_number": "262-242-0051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POWELL",
        "first_name": "PAMELA",
        "middle_name": "D.",
        "credential": "APNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-11-19",
        "last_updated": "2015-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "5158",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PAMELA",
            "last_name": "SAMPE",
            "middle_name": "D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Mequon, WI

Sources for this page

Verify at the official NPI Registry.