Individual provider Active NPI

Christine M Johnsen, MS, APNP, ANP-BC

  • Adult Health Nurse Practitioner
  • Wausau, WI
National Provider Identifier
1316274293
Registry record updated Dec 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
3915-33 Issued in WI
Practice address
425 Pine Ridge Blvd
Suite 211
Wausau, WI 54401-4123
Phone
(715) 845-5505
Fax
(715) 848-2884
NPI assigned
Nov 12, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Clinical Nurse Specialist 364SA2200X 3915-33 WI
Adult Health Nurse Practitioner 363LA2200X 3915-33 WI Primary

Addresses

Primary practice location

425 Pine Ridge Blvd
Suite 211
Wausau, WI 54401-4123

Mailing address

5801 Granite Rd
Wausau, WI 54403-9620
Phone (715) 842-2115

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
3915-33WIMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Pain Management SC Past Accepting new patients
Advanced Pain Management, SC Past Accepting new patients

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": "1257984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323820800000",
    "number": "1316274293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5801 GRANITE RD",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544039620",
            "telephone_number": "715-842-2115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 PINE RIDGE BLVD",
            "address_2": "SUITE 211",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544014123",
            "telephone_number": "715-845-5505",
            "fax_number": "715-848-2884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSEN",
        "first_name": "CHRISTINE",
        "middle_name": "M",
        "credential": "MS, APNP, ANP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-11-12",
        "last_updated": "2011-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SA2200X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Adult Health",
            "state": "WI",
            "license": "3915-33",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "WI",
            "license": "3915-33",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wausau, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.