Individual provider Active NPI

Brenda Blunt, APNP

  • Nurse Practitioner
  • Grafton, WI
National Provider Identifier
1174878839
Registry record updated Oct 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
4877 Issued in WI
Practice address
975 Port Washington Rd
Grafton, WI 53024-9201
Phone
(262) 329-3127
NPI assigned
Jul 18, 2012
Last updated
Oct 5, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 4877 WI Primary
Family Nurse Practitioner 363LF0000X 4877-33 WI

Addresses

Primary practice location

975 Port Washington Rd
Grafton, WI 53024-9201

Mailing address

PO Box 735044
Chicago, IL 60673-5044
Phone (800) 326-2250

Other practice location 1

2801 W Kinnickinnic River Pkwy Ste 1030
Milwaukee, WI 53215-5217
Phone (414) 908-6500

Other practice location 2

2801 W Kinnickinnic River Pkwy Ste 1030
Milwaukee, WI 53215-5217
Phone (414) 908-6500

Other practice location 3

5900 S Lake Dr
Cudahy, WI 53110-3171
Phone (414) 489-9000

Other identifiers 1

IdentifierTypeStateIssuer
100036842MedicaidWI

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address bblunt45465@direct.myadvocateaurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

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
I20130923000591 WI Practitioner - Nurse Practitioner 8921242454 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aurora Medical Group, Inc.Group PAC ID 6709794258, 3,764 clinicians
Lakeshore Medical Clinic LLCGroup PAC ID 7719890730, 375 clinicians
Aurora Advanced Healthcare, Inc.Group PAC ID 3375625833, 1,107 clinicians

Practice addresses (Care Compare)

1020 N 12TH St
Milwaukee, WI 53233-1308
Phone (414) 219-3056

2000 E Layton Ave
Saint Francis, WI 53235-6053
Phone (414) 744-6589

2900 W Oklahoma Ave
Milwaukee, WI 53215-4330
Phone (414) 646-5410

3003 W Good Hope Rd
Milwaukee, WI 53209-2042
Phone (414) 352-3100

5900 S Lake Dr
Cudahy, WI 53110-3171
Phone (414) 489-4190

8901 W Lincoln Ave
West Allis, WI 53227-2409
Phone (414) 329-5930

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4877WIMDNurse Practitioner
4877-33WIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeshore Medical Clinic, LLC CurrentSince Aug 1, 2013 Accepting new patients
Lakeshore Medical Clinic LTD CurrentSince Aug 1, 2013 Accepting new patients
Aurora Advanced Healthcare, Inc. CurrentSince Apr 28, 2025 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Dec 14, 2014 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Dec 14, 2014 Accepting new patients
Aurora Advanced Healthcare Inc CurrentSince Apr 28, 2025 Accepting new patients
Aurora Medical Group, Inc. Past Accepting new patients

Locations

5900 S Lake Dr
Cudahy, WI 53110
Phone (414) 489-4055

3003 W Good Hope Rd
Glendale, WI 53209
Phone (414) 352-3100

12203 N Corporate Pkwy
Mequon, WI 53092
Phone (262) 387-8200

1020 N 12th St
Milwaukee, WI 53233
Phone (414) 219-3056

2801 W Kinnickinnic River Pkwy
Ste 1030
Milwaukee, WI 53215
Phone (414) 649-5200

S74W16775 Janesville Rd
Muskego, WI 53150
Phone (414) 422-4747

2000 E Layton Ave
St Francis, WI 53235
Phone (414) 744-7880

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

Hospital & facility affiliations 3

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": "1342569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1791158400000",
    "number": "1174878839",
    "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": "975 PORT WASHINGTON RD",
            "city": "GRAFTON",
            "state": "WI",
            "postal_code": "530249201",
            "telephone_number": "262-329-3127"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2801 W Kinnickinnic River Pkwy Ste 1030",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532155217",
            "country_code": "US",
            "telephone_number": "414-908-6500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2801 W Kinnickinnic River Pkwy Ste 1030",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532155217",
            "country_code": "US",
            "telephone_number": "414-908-6500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5900 S Lake Dr",
            "address_purpose": "LOCATION",
            "city": "Cudahy",
            "state": "WI",
            "postal_code": "531103171",
            "country_code": "US",
            "telephone_number": "414-489-9000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLUNT",
        "first_name": "BRENDA",
        "name_prefix": "Mrs.",
        "credential": "APNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-18",
        "last_updated": "2026-10-05",
        "certification_date": "2026-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "4877",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "4877-33",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100036842",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bblunt45465@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2801 W Kinnickinnic River Pkwy Ste 1030",
            "city": "Milwaukee",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532155217",
            "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": "2801 W Kinnickinnic River Pkwy Ste 1030",
            "city": "Milwaukee",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532155217",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Grafton, WI

Sources for this page

Verify at the official NPI Registry.