Individual provider Active NPI

Veronica L Sanderson

  • Nurse Practitioner
  • Janesville, WI
National Provider Identifier
1194566828
Registry record updated Jul 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
15317-33 Issued in WI
Practice address
3200 E Racine St
Janesville, WI 53546-2343
Phone
(608) 371-8000
Fax
(608) 371-8938
NPI assigned
Jun 5, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 15317-33 WI
Nurse Practitioner 363L00000X 15317-33 WI Primary

Addresses

Primary practice location

3200 E Racine St
Janesville, WI 53546-2343

Mailing address

3200 E Racine St
Janesville, WI 53546-2343
Phone (608) 371-8000

Other identifiers 1

IdentifierTypeStateIssuer
1194566828MedicaidWI

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
I20240814003742 WI Practitioner - Nurse Practitioner 4587102132 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Dean Health Systems IncGroup PAC ID 7012827983, 1,174 clinicians

Practice addresses (Care Compare)

3200 E Racine St
Janesville, WI 53546-2343
Phone (608) 371-8000

Hospital & facility affiliations

  • SSM Health at Home Home Health-Wisconsin Home health agency, Madison, WI, CCN 527184
  • Agrace Hospicecare Hospice, Madison, WI, CCN 521505
  • SSM Health St Mary'S Hospital - Janesville Hospital, Janesville, WI, CCN 520208
  • Edgerton Hospital and Health Services Hospital, Edgerton, WI, CCN 521319

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
15317-33WIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Dean Health Systems, Inc CurrentSince Aug 1, 2024 Accepting new patients
Dean Health Systems, Inc. CurrentSince Aug 1, 2024 Accepting new patients

Locations

3200 E Racine St
Janesville, WI 53546
Phone (608) 371-8000

1808 W Beltline Hwy
Madison, WI 53713
Phone (608) 250-1497

515 22nd Ave
Monroe, WI 53566
Phone (608) 324-1000

Interoperability endpoints

  • Direct secure messaging: vsanderson516330@direct-ehr-ssmhc.com

Organizations & group practices 2

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 5

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": "1717545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722297600000",
    "number": "1194566828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3200 E RACINE ST",
            "city": "JANESVILLE",
            "state": "WI",
            "postal_code": "535462343",
            "telephone_number": "608-371-8000",
            "fax_number": "608-371-8938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 E RACINE ST",
            "city": "JANESVILLE",
            "state": "WI",
            "postal_code": "535462343",
            "telephone_number": "608-371-8000",
            "fax_number": "608-371-8938"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDERSON",
        "first_name": "VERONICA",
        "middle_name": "L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-05",
        "last_updated": "2024-07-30",
        "certification_date": "2024-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "15317-33",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "15317-33",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1194566828",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Janesville, WI

Sources for this page

Verify at the official NPI Registry.