Active NPI
Nina M Malm, APRN, CNP
- Gerontology Nurse Practitioner
- Rochester, MN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gerontology Nurse Practitioner
- License
- 5629
- Practice address
- 5067 55TH St NW
Rochester, MN 55901-3809 - Phone
- (507) 292-7070
- NPI assigned
- Jan 30, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 5655 | WI | |
| Adult Health Nurse Practitioner | 363LA2200X | 5655 | WI | |
| Gerontology Nurse Practitioner | 363LG0600X | 5655 | WI | |
| Gerontology Nurse Practitioner | 363LG0600X | 5629 | MN | Primary |
Addresses
Primary practice location
5067 55TH St NW
Rochester, MN 55901-3809
Mailing address
5067 55TH St NW
Rochester, MN 55901-3809
Phone (507) 292-7070
Other practice location 1
130 2nd St
Neenah, WI 54956-2883
Phone (920) 725-0077
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2013
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
425 Pine Ridge Blvd
Wausau, WI 54401-4123
Phone (715) 843-1067
Hospital & facility affiliations
- Aspirus Wausau Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Nurse Practitioner, Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5629 | MN | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Aspirus Wausau Hospital, Inc. | Current | Accepting new patients | |
| Thedacare, Incorporated | Current | Accepting new patients | |
| Matrix Medical Plus | Nurse Practitioner | Current | Accepting new patients |
| Aspirus Wausau Hospital Inc | Current | Accepting new patients | |
| Aspirus Wausau Hospital, Inc. | Current | Accepting new patients | |
| Aspirus Medical Group, Inc. | Past | Accepting new patients |
Locations
9201 E Mountain View Rd
Ste 220
Scottsdale, AZ 85258
Phone (480) 862-1883
29980 Network Pl
Chicago, IL 60673
4480 W Spencer St
Appleton, WI 54914
Phone (920) 738-4800
250 E Wisconsin Ave
Fl 18
Milwaukee, WI 53202
Phone (303) 748-5781
130 2nd St
Neenah, WI 54956
Phone (920) 729-2063
600 N Westhaven Dr
Oshkosh, WI 54904
Phone (920) 237-5000
425 Pine Ridge Blvd
Wausau, WI 54401
Phone (715) 847-2400
333 Pine Ridge Blvd
Wausau, WI 54401
Phone (715) 847-2160
Organizations & group practices 6
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.
-
- Clinic/Center
- Wausau, WI
- NPI 1922321140
-
- Family Medicine Physician
- New London, WI
- NPI 1376656959
-
- Dermatology Physician
- Wausau, WI
- NPI 1477883759
-
- Hospice and Palliative Medicine (Internal Medicine) Physician
- Wausau, WI
- NPI 1225905102
-
- Clinic/Center
- Weston, WI
- NPI 1720177371
Hospital & facility affiliations 10
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Wausau, WI
- NPI 1558363986
-
- General Acute Care Hospital
- Stevens Point, WI
- NPI 1598375271
-
- General Acute Care Hospital
- Wausau, WI
- NPI 1902923170
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1391040000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1721347200000",
"number": "1336562172",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5067 55TH ST NW",
"city": "ROCHESTER",
"state": "MN",
"postal_code": "559013809",
"telephone_number": "507-292-7070"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5067 55TH ST NW",
"city": "ROCHESTER",
"state": "MN",
"postal_code": "559013809",
"telephone_number": "507-292-7070"
}
],
"practiceLocations": [
{
"address_1": "130 2nd St",
"address_purpose": "LOCATION",
"city": "Neenah",
"state": "WI",
"postal_code": "549562883",
"country_code": "US",
"telephone_number": "920-725-0077",
"fax_number": "920-725-6535",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MALM",
"first_name": "NINA",
"middle_name": "M",
"credential": "APRN, CNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-01-30",
"last_updated": "2024-07-19",
"certification_date": "2024-07-19",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "WI",
"license": "5655",
"primary": false
},
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "WI",
"license": "5655",
"primary": false
},
{
"code": "363LG0600X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Gerontology",
"state": "WI",
"license": "5655",
"primary": false
},
{
"code": "363LG0600X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Gerontology",
"state": "MN",
"license": "5629",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Rochester, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.