Individual provider Active NPI

Julie M Henry, OD

  • Optometrist
  • Fond Du Lac, WI
National Provider Identifier
1295842805
Registry record updated Sep 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2979-035 Issued in WI
Practice address
210 Wisconsin American Dr
Fond Du Lac, WI 54935
Phone
(920) 907-7000
Fax
(920) 907-7012
NPI assigned
Aug 23, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2979-035 WI Primary

Addresses

Primary practice location

210 Wisconsin American Dr
Fond Du Lac, WI 54935

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
38628000MedicaidWI

Other names 1

  • Julie Marie Ronk Doing business as

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address jhenry42462@direct.myadvocateaurora.org
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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041213000118 WI Practitioner - Optometry 5890752851 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aurora Medical Group, Inc.Group PAC ID 6709794258, 3,764 clinicians

Practice addresses (Care Compare)

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

210 Wisconsin American Dr
Fond Du Lac, WI 54937-2999
Phone (920) 907-4800

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery82

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2979-035WIMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Aurora Medical Group, Inc. CurrentSince Oct 31, 2005 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Oct 31, 2005 Accepting new patients
Aurora Medical Group, Inc. Past Accepting new patients

Locations

210 Wisconsin American Dr
Fond du Lac, WI 54937
Phone (920) 907-7000

2733 S Ridge Rd
Green Bay, WI 54304
Phone (920) 497-6200

3301 W Forest Home Ave
Milwaukee, WI 53215
Phone (414) 389-2233

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

2414 Kohler Memorial Dr
Sheboygan, WI 53081
Phone (920) 457-4461

Organizations & group practices 3

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": "1156291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756771200000",
    "number": "1295842805",
    "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": "210 WISCONSIN AMERICAN DR",
            "city": "FOND DU LAC",
            "state": "WI",
            "postal_code": "54935",
            "telephone_number": "920-907-7000",
            "fax_number": "920-907-7012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENRY",
        "first_name": "JULIE",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-23",
        "last_updated": "2025-09-02",
        "certification_date": "2025-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WI",
            "license": "2979-035",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38628000",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jhenry42462@direct.myadvocateaurora.org",
            "affiliation": "N",
            "address_1": "210 Wisconsin American Dr",
            "city": "Fond du Lac",
            "state": "WI",
            "country_code": "US",
            "postal_code": "54935",
            "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": "210 Wisconsin American Dr",
            "city": "Fond du Lac",
            "state": "WI",
            "country_code": "US",
            "postal_code": "54935",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JULIE",
            "last_name": "RONK",
            "middle_name": "MARIE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fond Du Lac, WI

Sources for this page

Verify at the official NPI Registry.