Individual provider Active NPI

Laurel L Denheijer, APNP

  • Family Nurse Practitioner
  • Green Bay, WI
National Provider Identifier
1356446520
Registry record updated Apr 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1597-33 Issued in WI
Practice address
923 Eliza St
Green Bay, WI 54301-3234
Phone
(920) 965-4800
Fax
(920) 965-4801
NPI assigned
Sep 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2020

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 1597-33 WI Primary
Nurse Practitioner 363L00000X 1597003 WI

Addresses

Primary practice location

923 Eliza St
Green Bay, WI 54301-3234

Mailing address

PO Box 22487
Green Bay, WI 54305-2487
Phone (920) 445-7226

Other identifiers 2

IdentifierTypeStateIssuer
43983000MedicaidWI
0342125OtherAMERICAN NURSES CREDENTIALING CENTER

Other names 1

  • Laurel L Sickinger 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
I20050912000990 WI Practitioner - Nurse Practitioner 7214960103 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1597WIMDGeneral Practice Dentistry
1597003WIMDNurse Practitioner
1597-33WIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Bellin Memorial Hospital Inc CurrentSince Apr 7, 2017 Accepting new patients
Bellin Memorial Hospital Inc Current Accepting new patients
Bellin Memorial Hospital Inc CurrentSince Apr 7, 2017 Accepting new patients

Locations

923 Eliza St
Green Bay, WI 54301
Phone (920) 965-4700

744 S Webster Ave
Green Bay, WI 54301
Phone (920) 433-6025

1765 N 18th St
Manitowoc, WI 54220
Phone (920) 482-0575

607 E Bronson Rd
Seymour, WI 54165
Phone (920) 833-6856

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": "1158105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587340800000",
    "number": "1356446520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 22487",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543052487",
            "telephone_number": "920-445-7226",
            "fax_number": "920-445-7289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "923 ELIZA ST",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543013234",
            "telephone_number": "920-965-4800",
            "fax_number": "920-965-4801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DENHEIJER",
        "first_name": "LAUREL",
        "middle_name": "L",
        "credential": "APNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-13",
        "last_updated": "2020-04-20",
        "certification_date": "2020-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "1597-33",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "1597003",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "43983000",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICAN NURSES CREDENTIALING CENTER",
            "identifier": "0342125",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAUREL",
            "last_name": "SICKINGER",
            "middle_name": "L",
            "credential": "APNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Green Bay, WI

Sources for this page

Verify at the official NPI Registry.