NPIMap

Individual provider Active NPI

Heather Meeusen

  • Primary Care Nurse Practitioner
  • Plymouth, WI
National Provider Identifier
1205212214
Registry record updated Aug 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
172850-30 Issued in WI
Practice address
825 Walton Dr
Plymouth, WI 53073-5022
Phone
(920) 893-0903
NPI assigned
Aug 3, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X 172850-30 WI Primary

Addresses

Primary practice location

825 Walton Dr
Plymouth, WI 53073-5022

Mailing address

825 Walton Dr
Plymouth, WI 53073-5022
Phone (920) 893-0903

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151029001975 WI Practitioner - Nurse Practitioner 0446560635 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1411 N Taylor Dr
Sheboygan, WI 53081-3043
Phone (920) 457-4858

15 S 10TH St
Suite a
Oostburg, WI 53070-1370
Phone (920) 552-5046

1821 S Webster Ave
Green Bay, WI 54301-2253
Phone (920) 496-4700

3021 Voyager Dr
Green Bay, WI 54311-8303
Phone (920) 496-4700

3100 Superior Ave
Sheboygan, WI 53081-1948
Phone (920) 459-8300

3113 Saemann Ave
Sheboygan, WI 53081-1957
Phone (920) 496-4700

3750 Investors CT
Grand Chute, WI 54913-2330
Phone (920) 496-4700

4810 Expo Dr
Manitowoc, WI 54220-9341
Phone (920) 717-0800

835 S Van Buren St
Green Bay, WI 54301-3526
Phone (920) 496-4700

950 Woodlake Rd
Kohler, WI 53044-1348
Phone (920) 783-3150

PO Box
Suite 19070
Green Bay, WI 54307-9070

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.81 of 100Reported as apm
Quality
85.98
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
94.81 of 100Reported as apm
Quality
85.98
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
6538WIMDProfessional Counselor
172850-30WIMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St Vincent Hospital-Hospital Sisters-Third Order of St Francis CurrentSince Nov 10, 2020 Accepting new patients
St Nicholas Hospital-Sisters of the Third Order of St Francis CurrentSince Sep 19, 2015 Accepting new patients
St Vincent Hospital-Hospital Sisters-Third Order of St Francis CurrentSince Nov 10, 2020 Accepting new patients
St. Nicholas Hospital-Sisters of the Third Order of St Francis CurrentSince Sep 19, 2015 Accepting new patients
St. Nicholas Hospital-Sisters of the Third Order of St Francis Current Accepting new patients

Locations

835 S Van Buren St
Green Bay, WI 54301
Phone (888) 901-7246

4810 Expo Dr
Manitowoc, WI 54220
Phone (920) 717-0800

825 Walton Dr
Plymouth, WI 53073
Phone (920) 889-0302

3100 Superior Ave
Sheboygan, WI 53081
Phone (800) 472-6710

Organizations & group practices 5

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 8

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": "1438560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438560000000",
    "number": "1205212214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 WALTON DR",
            "city": "PLYMOUTH",
            "state": "WI",
            "postal_code": "530735022",
            "telephone_number": "920-893-0903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 WALTON DR",
            "city": "PLYMOUTH",
            "state": "WI",
            "postal_code": "530735022",
            "telephone_number": "920-893-0903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEEUSEN",
        "first_name": "HEATHER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-03",
        "last_updated": "2015-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "WI",
            "license": "172850-30",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth, WI

Sources for this page

Verify at the official NPI Registry.