Individual provider Active NPI

Kerry A Talbert, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Green Bay, WI
National Provider Identifier
1336691062
Registry record updated May 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
7349 Issued in WI
Practice address
480 Pilgrim Way # 1300-a
Green Bay, WI 54304-5280
Phone
(920) 610-5119
Fax
(920) 610-5120
NPI assigned
Oct 28, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 13, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 7439 WI
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 7349 WI Primary

Addresses

Primary practice location

480 Pilgrim Way # 1300-a
Green Bay, WI 54304-5280

Mailing address

1900 Silver Lake Rd NW Ste 110
New Brighton, MN 55112-1789
Phone (651) 628-9566

Other identifiers 1

IdentifierTypeStateIssuer
2627165705OtherWIPHONE

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
I20161129002421 WI Practitioner - Nurse Practitioner 0840570396 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

10000 Innovation Dr
Milwaukee, WI 53226

1900 Silver Lake Rd NW
New Brighton, MN 55112-1786

1900 Silver Lake Rd NW
Suite 110
New Brighton, MN 55112-1789

4703 S 10TH St
Manitowoc, WI 54220-9119

N74W12501 Leatherwood Court
Suite 304
Menomonee Falls, WI 53051-4490

PO Box
Suite 19070
Green Bay, WI 54307-9070

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
7439WIMDFamily Nurse Practitioner
7349WIMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Talbert Mental Health LLC Psychiatric/Mental Health Current Accepting new patients
Froedtert &the Medical College of Wisconsin Community Physicians, Inc. CurrentSince Jul 3, 2019 Accepting new patients
Froedtert &the Medical College of Wisconsin Community Physicians, Inc. CurrentSince Jul 3, 2019 Accepting new patients

Locations

W168N11237 Western Ave
Germantown, WI 53022
Phone (262) 253-5060

924 N Taylor Dr
Sheboygan, WI 53081
Phone (920) 395-7210

1155 N Mayfair Rd
Wauwatosa, WI 53226
Phone (414) 955-5990

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": "1477612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715558400000",
    "number": "1336691062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 SILVER LAKE RD NW STE 110",
            "city": "NEW BRIGHTON",
            "state": "MN",
            "postal_code": "551121789",
            "telephone_number": "651-628-9566",
            "fax_number": "651-628-0411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "480 PILGRIM WAY # 1300-A",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543045280",
            "telephone_number": "920-610-5119",
            "fax_number": "920-610-5120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TALBERT",
        "first_name": "KERRY",
        "middle_name": "A",
        "name_prefix": "Miss",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-10-28",
        "last_updated": "2024-05-13",
        "certification_date": "2024-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "7439",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WI",
            "license": "7349",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHONE",
            "identifier": "2627165705",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Green Bay, WI

Sources for this page

Verify at the official NPI Registry.