Individual provider Active NPI

Brook Leigh Ronsman, APNP

  • Family Nurse Practitioner
  • Kewaunee, WI
National Provider Identifier
1154091189
Registry record updated Oct 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
13863-33 Issued in WI
Practice address
575 4TH St
Kewaunee, WI 54216-1785
Phone
(920) 388-4640
Fax
(920) 388-0479
NPI assigned
Sep 21, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 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 13863-33 WI Primary

Addresses

Primary practice location

575 4TH St
Kewaunee, WI 54216-1785

Mailing address

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

Other practice location 1

140B School Creek Trl
Luxemburg, WI 54217-1095
Phone (920) 845-1370

Other practice location 2

2935 Durham Rd
Green Bay, WI 54311-7296
Phone (906) 295-0008

Other practice location 3

831 Parker Ave
Algoma, WI 54201-1808
Phone (920) 487-3676

Other identifiers 1

IdentifierTypeStateIssuer
2023002571OtherAMERICAN NURSES CREDENTIALING CENTER

Other names 1

  • Brook L Beaudo 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
I20230524001853 WI Practitioner - Nurse Practitioner 5698131266 Reassigns benefits to 1 organization

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
Oconto Hospital and Medical Center IncGroup PAC ID 2163461781, shared by 12 NPIs, 217 clinicians
Bellin Memorial Hospital IncGroup PAC ID 8820900749, 685 clinicians

Practice addresses (Care Compare)

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

575 4TH St
Kewaunee, WI 54216-1785
Phone (920) 388-4640

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
13863-33WIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Bellin Memorial Hospital Inc Current Accepting new patients
Bellin Memorial Hospital Inc CurrentSince May 11, 2023 Accepting new patients
Bellin Memorial Hospital Inc CurrentSince May 11, 2023 Accepting new patients
Bellin Memorial Hospital Inc Past Accepting new patients

Locations

831 Parker Ave
Algoma, WI 54201
Phone (920) 487-3084

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

575 4th St
Kewaunee, WI 54216
Phone (920) 388-4640

140 School Creek Trl
#B
Luxemburg, WI 54217
Phone (920) 845-1370

Interoperability endpoints

  • Direct secure messaging: bronsman926270@direct.emplifyhealth.org

Organizations & group practices 4

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 2

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": "1632182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698105600000",
    "number": "1154091189",
    "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": "575 4TH ST",
            "city": "KEWAUNEE",
            "state": "WI",
            "postal_code": "542161785",
            "telephone_number": "920-388-4640",
            "fax_number": "920-388-0479"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "140B School Creek Trl",
            "address_purpose": "LOCATION",
            "city": "Luxemburg",
            "state": "WI",
            "postal_code": "542171095",
            "country_code": "US",
            "telephone_number": "920-845-1370",
            "fax_number": "920-845-1379",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2935 Durham Rd",
            "address_purpose": "LOCATION",
            "city": "Green Bay",
            "state": "WI",
            "postal_code": "543117296",
            "country_code": "US",
            "telephone_number": "906-295-0008",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "831 Parker Ave",
            "address_purpose": "LOCATION",
            "city": "Algoma",
            "state": "WI",
            "postal_code": "542011808",
            "country_code": "US",
            "telephone_number": "920-487-3676",
            "fax_number": "920-487-3084",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RONSMAN",
        "first_name": "BROOK",
        "middle_name": "LEIGH",
        "credential": "APNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-21",
        "last_updated": "2023-10-24",
        "certification_date": "2023-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "13863-33",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICAN NURSES CREDENTIALING CENTER",
            "identifier": "2023002571",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BROOK",
            "last_name": "BEAUDO",
            "middle_name": "L",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Kewaunee, WI

Sources for this page

Verify at the official NPI Registry.