NPIMap

Individual provider Active NPI

Kristin Marie Gardon, NP

  • Family Nurse Practitioner
  • Green Bay, WI
National Provider Identifier
1366933608
Registry record updated Dec 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
8502-33 Issued in WI
Practice address
835 S. Van Buren St.
Green Bay, WI 54301
Phone
(920) 433-8586
Fax
(920) 884-5306
NPI assigned
May 22, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2021

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 8502-33 WI Primary
Wound Care Registered Nurse 163WW0000X 178648-30 WI

Addresses

Primary practice location

835 S. Van Buren St.
Green Bay, WI 54301

Mailing address

835 S. Van Buren St.
Green Bay, WI 54301
Phone (920) 433-8586

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kgardon15578@ewd.direct.hshs.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180822000865 WI Practitioner - Nurse Practitioner 3779832902 Reassigns benefits to 7 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Vincent Hospital-Hospital Sisters-Third Order of St FrancisGroup PAC ID 5799694675, 593 clinicians
St Clare Memorial Hospital, IncGroup PAC ID 0446211395, 62 clinicians

Practice addresses (Care Compare)

2502 S Ashland Ave
Green Bay, WI 54304-5252
Phone (920) 496-4700

855 S Main St
Oconto Falls, WI 54154-1241

Hospital & facility affiliations

  • St Vincent Hospital Hospital, Green Bay, WI, CCN 520075
  • HSHS St Clare Memorial Hospital Hospital, Oconto Falls, WI, CCN 521310

Merit-based Incentive Payment System (MIPS)

Final score
94.81 of 100Reported as apm
Quality
85.98
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
94.81 of 100Reported as apm
Quality
85.98
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
178648-30WIMDWound Care Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
St Vincent Hospital-Hospital Sisters-Third Order of St Francis CurrentSince Jul 23, 2018 Accepting new patients
St Vincent Hospital-Hospital Sisters-Third Order of St Francis CurrentSince Jul 23, 2018 Accepting new patients
St Vincent Hospital-Hospital Sisters-Third Order of St Francis Current Accepting new patients
St. Nicholas Hospital-Sisters of the Third Order of St Francis CurrentSince Jul 23, 2018 Accepting new patients
Prevea Clinic, Inc. CurrentSince Jul 23, 2018 Accepting new patients
St. Clare Memorial Hospital, Inc CurrentSince Aug 23, 2018 Accepting new patients
St Nicholas Hospital-Sisters of the Third Order of St Francis CurrentSince Jul 23, 2018 Accepting new patients
St. Vincent Hospital-Hospital Sisters-Third Order of St. Francis CurrentSince Aug 23, 2018 Accepting new patients
American Current Care PA Current Accepting new patients
St Mary'S Hospital Medical Center of Green Bay Inc.-Hospital Sisters CurrentSince Aug 23, 2018 Accepting new patients
Prevea Clinic, Inc. CurrentSince Jul 23, 2018 Accepting new patients
St Clare Memorial Hospital, Inc CurrentSince Aug 23, 2018 Accepting new patients

Locations

2661 County Highway I
Chippewa Fls, WI 54729
Phone (715) 717-7200

1726 Shawano Ave
Green Bay, WI 54303
Phone (920) 432-6016

835 S Van Buren St
Green Bay, WI 54301
Phone (888) 901-7246

2502 S Ashland Ave
Green Bay, WI 54304
Phone (920) 496-4750

358 Junction Rd
Madison, WI 53717
Phone (608) 829-1888

215 N 35th St
Milwaukee, WI 53208
Phone (414) 931-7600

855 S Main St
Ste 1
Oconto Falls, WI 54154
Phone (920) 846-8187

3100 Superior Ave
Sheboygan, WI 53081
Phone (800) 472-6710

323 S 18th Ave
Sturgeon Bay, WI 54235
Phone (920) 743-5566

Interoperability endpoints

  • Direct secure messaging: kgardon15578@ewd.direct.hshs.org

Organizations & group practices 32

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.

View all 32

Hospital & facility affiliations 9

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1526947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639612800000",
    "number": "1366933608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "835 S. VAN BUREN ST.",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "54301",
            "telephone_number": "920-433-8586",
            "fax_number": "920-884-5306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "835 S. VAN BUREN ST.",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "54301",
            "telephone_number": "920-433-8586",
            "fax_number": "920-884-5306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARDON",
        "first_name": "KRISTIN",
        "middle_name": "MARIE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-22",
        "last_updated": "2021-12-16",
        "certification_date": "2021-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "8502-33",
            "primary": true
        },
        {
            "code": "163WW0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Wound Care",
            "state": "WI",
            "license": "178648-30",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kgardon15578@ewd.direct.hshs.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "835 S. Van Buren St.",
            "city": "Green Bay",
            "state": "WI",
            "country_code": "US",
            "postal_code": "54301",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Green Bay, WI

Sources for this page

Verify at the official NPI Registry.