Individual provider Active NPI

Nichole Feldman, FNP-C

  • Family Nurse Practitioner
  • Fort Atkinson, WI
National Provider Identifier
1174285787
Registry record updated Jun 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
14634-33 Issued in WI
Practice address
1520 Madison Ave
Fort Atkinson, WI 53538-3100
Phone
(920) 563-5500
NPI assigned
Oct 11, 2021
Last updated
Jun 26, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 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 14634-33 WI Primary

Addresses

Primary practice location

1520 Madison Ave
Fort Atkinson, WI 53538-3100

Mailing address

PO Box 249
Fort Atkinson, WI 53538-0249
Phone (920) 563-4466

Other identifiers 1

IdentifierTypeStateIssuer
1174285787MedicaidWI

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
I20240117001213 WI Practitioner - Nurse Practitioner 3971993726 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cleanslate Medical Group of Wisconsin SCGroup PAC ID 4284905134, 26 clinicians
Fort Healthcare IncGroup PAC ID 0840189718, 159 clinicians

Practice addresses (Care Compare)

101 E Milwaukee St
Suite 315
Janesville, WI 53545-3002
Phone (833) 505-4673

611 E Sherman Ave
Fort Atkinson, WI 53538-1960
Phone (920) 568-5000

611 Sherman Ave E
Fort Atkinson, WI 53538-1960

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.51 of 100Reported as group
Quality
83.2
Promoting interoperability
77
Improvement activities
40
Cost
71.7

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
14634-33WIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Fort Healthcare Inc CurrentSince Oct 1, 2025 Accepting new patients
Fort Healthcare Inc Current Accepting new patients
Cleanslate Medical Group of Wisconsin, SC CurrentSince Jan 1, 2024 Accepting new patients
Fort Healthcare, Inc. CurrentSince Oct 1, 2025 Accepting new patients

Locations

8 Cadillac Dr
Ste 180
Brentwood, TN 37027

1520 Madison Ave
Fort Atkinson, WI 53538
Phone (920) 563-5500

611 Sherman Ave E
Fort Atkinson, WI 53538
Phone (920) 563-6667

377 W River Woods Pkwy
Ste 201
Glendale, WI 53212
Phone (414) 323-6880

101 E Milwaukee St
Ste 315
Janesville, WI 53545
Phone (608) 305-0201

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/8F7ruIta-JA7ecm4ommy-Q50dF1FkFe4/

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1633910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782432000000",
    "number": "1174285787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 249",
            "city": "FORT ATKINSON",
            "state": "WI",
            "postal_code": "535380249",
            "telephone_number": "920-563-4466",
            "fax_number": "920-568-4004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1520 MADISON AVE",
            "city": "FORT ATKINSON",
            "state": "WI",
            "postal_code": "535383100",
            "telephone_number": "920-563-5500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FELDMAN",
        "first_name": "NICHOLE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-11",
        "last_updated": "2026-06-26",
        "certification_date": "2026-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "14634-33",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1174285787",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Atkinson, WI

Sources for this page

Verify at the official NPI Registry.