Individual provider Active NPI

Amy Lee Mathison, APNP

  • Family Nurse Practitioner
  • Green Bay, WI
National Provider Identifier
1134845464
Registry record updated Mar 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
13225-33 Issued in WI
Practice address
704 S Webster Ave Ste 300
Green Bay, WI 54301-3528
Phone
(920) 338-6868
Fax
(920) 338-6869
NPI assigned
Oct 18, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 13225-33 WI Primary

Addresses

Primary practice location

704 S Webster Ave Ste 300
Green Bay, WI 54301-3528

Mailing address

PO Box 22487
Green Bay, WI 54305-2487
Phone (920) 445-7210

Other practice location 1

2820 Roosevelt Rd
Marinette, WI 54143-3834
Phone (715) 735-5225

Other identifiers 1

IdentifierTypeStateIssuer
F07220660OtherAMERICAN ACADEMY OF NURSE PRACTITIONERS

Other names 1

  • Amy Lee Bethe 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
I20221108000531 WI Practitioner - Nurse Practitioner 8426425281 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bellin Memorial Hospital IncGroup PAC ID 8820900749, 685 clinicians

Practice addresses (Care Compare)

2820 Roosevelt Rd
Marinette, WI 54143-3834
Phone (715) 735-5225

704 S Webster Ave
Green Bay, WI 54301-3533
Phone (920) 468-3444

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
13225-33WIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Bellin Memorial Hospital Inc CurrentSince Oct 26, 2022 Accepting new patients
Oconto Hospital & Medical Center Inc Current Accepting new patients
Bellin Memorial Hospital Inc CurrentSince Oct 26, 2022 Accepting new patients
Bellin Memorial Hospital Inc Current Accepting new patients
Oconto Hospital & Medical Center Inc CurrentSince Mar 28, 2023 Accepting new patients
Oconto Hospital & Medical Center, Inc. CurrentSince Mar 28, 2023 Accepting new patients
Bellin Memorial Hospital Inc Past Accepting new patients

Locations

744 S Webster Ave
Green Bay, WI 54301
Phone (920) 433-6025

2641 Development Dr
Green Bay, WI 54311

704 S Webster Ave
Ste 300
Green Bay, WI 54301
Phone (920) 433-6050

704 S Webster Ave
Green Bay, WI 54301
Phone (920) 433-3784

720 S Van Buren St
Ste 101
Green Bay, WI 54301
Phone (920) 430-8120

2820 Roosevelt Rd
Marinette, WI 54143
Phone (715) 330-6171

820 Arbutus Ave
Oconto, WI 54153
Phone (920) 835-1100

Interoperability endpoints

  • Direct secure messaging: amathison926240@direct.emplifyhealth.org
  • Direct secure messaging: amathison325904@direct.thedacare.org

Organizations & group practices 7

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": "1666051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679961600000",
    "number": "1134845464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 22487",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543052487",
            "telephone_number": "920-445-7210",
            "fax_number": "920-445-7289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "704 S WEBSTER AVE STE 300",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543013528",
            "telephone_number": "920-338-6868",
            "fax_number": "920-338-6869"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2820 Roosevelt Rd",
            "address_purpose": "LOCATION",
            "city": "Marinette",
            "state": "WI",
            "postal_code": "541433834",
            "country_code": "US",
            "telephone_number": "715-735-5225",
            "fax_number": "715-735-5388",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MATHISON",
        "first_name": "AMY",
        "middle_name": "LEE",
        "credential": "APNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-18",
        "last_updated": "2023-03-28",
        "certification_date": "2023-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "13225-33",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICAN ACADEMY OF NURSE PRACTITIONERS",
            "identifier": "F07220660",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMY",
            "last_name": "BETHE",
            "middle_name": "LEE",
            "credential": "APNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Green Bay, WI

Sources for this page

Verify at the official NPI Registry.