NPIMap

Individual provider Active NPI

Teal Calaway, NP

  • Family Nurse Practitioner
  • Kaukauna, WI
National Provider Identifier
1144979519
Registry record updated Sep 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11821-33 Issued in WI
Practice address
1746 Paul Dr
Kaukauna, WI 54130-3014
Phone
(920) 422-7404
Fax
(920) 543-5288
NPI assigned
Mar 22, 2022
Last updated
Sep 9, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2026

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 11821-33 WI Primary

Addresses

Primary practice location

1746 Paul Dr
Kaukauna, WI 54130-3014

Mailing address

3200 Alfa Romeo Rd
Green Bay, WI 54313-9215
Phone (920) 255-3369

Other practice location 1

1351 Ontario Rd
Green Bay, WI 54311-8302
Phone (888) 379-5539

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230623001318 WI Practitioner - Nurse Practitioner 5890153894 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sequoia Integrative Medical Services LLCGroup PAC ID 8527480250, 15 clinicians

Practice addresses (Care Compare)

1351 Ontario Rd
Green Bay, WI 54311-8302
Phone (920) 328-1220

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11821-33WIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sequoia Integrative Medical Services LLC CurrentSince Jun 1, 2023 Accepting new patients

Locations

1351 Ontario Rd
Green Bay, WI 54311
Phone (920) 328-1220

Organizations & group practices 1

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 18

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 18

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1647907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788912000000",
    "number": "1144979519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3200 ALFA ROMEO RD",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543139215",
            "telephone_number": "920-255-3369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1746 PAUL DR",
            "city": "KAUKAUNA",
            "state": "WI",
            "postal_code": "541303014",
            "telephone_number": "920-422-7404",
            "fax_number": "920-543-5288"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1351 Ontario Rd",
            "address_purpose": "LOCATION",
            "city": "Green Bay",
            "state": "WI",
            "postal_code": "543118302",
            "country_code": "US",
            "telephone_number": "888-379-5539",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CALAWAY",
        "first_name": "TEAL",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-22",
        "last_updated": "2026-09-09",
        "certification_date": "2026-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "11821-33",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kaukauna, WI

Sources for this page

Verify at the official NPI Registry.