Molly Lyn Anderson, WHNP-BC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

15565 Issued in WI

Practice address

1005 Spring City Dr
Waukesha, WI 53186-5934

Phone

(262) 301-2020

NPI assigned

Dec 24, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 3

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

Specialty

Nurse Practitioner

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Aurora Medical Group, Inc. 3,764 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: manderson409323@direct.myadvocateaurora.org

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.

• Aurora Medical Group, Inc.

  • Certified Registered Nurse Anesthetist
  • Milwaukee, WI
  • NPI 1427271378

  WI

  Medicare reassignment NPD
• Aurora Medical Group, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Oshkosh, WI
  • NPI 1326858044
  NPD
• Aurora Medical Group, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Manitowoc, WI
  • NPI 1801941075
  NPD (past)

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

{
    "created_epoch": "1482537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732492800000",
    "number": "1154866374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 735044",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606735044",
            "telephone_number": "800-326-2250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1005 SPRING CITY DR",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531865934",
            "telephone_number": "262-301-2020"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10735 W 159th St",
            "address_purpose": "LOCATION",
            "city": "Orland Park",
            "state": "IL",
            "postal_code": "604674531",
            "country_code": "US",
            "telephone_number": "708-873-7775",
            "fax_number": "708-873-0192",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "MOLLY",
        "middle_name": "LYN",
        "credential": "WHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-12-24",
        "last_updated": "2024-11-25",
        "certification_date": "2024-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "IL",
            "license": "209015302",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "15565",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100291312",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "manderson171319@dulyhealthandcare.direct-ci.com",
            "affiliation": "N",
            "address_1": "10735 W 159th St",
            "city": "Orland Park",
            "state": "IL",
            "country_code": "US",
            "postal_code": "604674531",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "1005 Spring City Dr",
            "city": "Waukesha",
            "state": "WI",
            "country_code": "US",
            "postal_code": "531865934",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "manderson409323@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1005 Spring City Dr",
            "city": "Waukesha",
            "state": "WI",
            "country_code": "US",
            "postal_code": "531865934",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Imelda Mary Anderson, REGISTERED NURSE
• Jason Anderson, LAT
• Kaity Anderson, LPC-IT
• Kathleen Marie Anderson, RDH
• Lisa Annette Anderson, LPN
• Rachel Leman Anderson, PA-C
• Katherine Elizabeth Andrew, APNP
• Susan A. Andrews
• Mary E Andruszkiewicz, RD, CD
• Kelly J Anello, DC

• All providers in Waukesha, WI
• Nurse Practitioner in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.