Individual provider Active NPI

Brianna Lynn Kuchelmeister, N.P.

  • Nurse Practitioner
  • Wausau, WI
National Provider Identifier
1215717632
Registry record updated Jan 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
13782 Issued in WI
Practice address
333 Pine Ridge Blvd
Wausau, WI 54401
Phone
(800) 283-2881
NPI assigned
Oct 3, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 13782 WI Primary

Addresses

Primary practice location

333 Pine Ridge Blvd
Wausau, WI 54401

Mailing address

N3977 McHugh Rd
Freedom, WI 54130
Phone (920) 256-1748

Other names 1

  • Brianna Lynn Vandenberg Former name

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
I20240207000074 WI Practitioner - Nurse Practitioner 2668815655 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
13782WIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Signify Health Medical Associates, PLLC Nurse Practitioner CurrentSince Mar 16, 2024 Accepting new patients
Urgent Care Physcians, LTD CurrentSince Apr 1, 2024 Accepting new patients

Locations

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

4055 Valley View Ln
Ste 700
Dallas, TX 75244
Phone (469) 466-7424

3329 Express Ct
Appleton, WI 54915
Phone (920) 733-5900

811 E Washington Ave
Madison, WI 53703
Phone (469) 466-7420

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.

NPI Registry JSON

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

{
    "created_epoch": "1696291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705968000000",
    "number": "1215717632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "N3977 MCHUGH RD",
            "city": "FREEDOM",
            "state": "WI",
            "postal_code": "54130",
            "telephone_number": "920-256-1748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 PINE RIDGE BLVD",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "54401",
            "telephone_number": "800-283-2881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUCHELMEISTER",
        "first_name": "BRIANNA",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-10-03",
        "last_updated": "2024-01-23",
        "certification_date": "2024-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "13782",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRIANNA",
            "last_name": "VANDENBERG",
            "middle_name": "LYNN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Wausau, WI

Sources for this page

Verify at the official NPI Registry.