Individual provider Active NPI

Michael Robert Oconnell, APNP

  • Family Nurse Practitioner
  • Appleton, WI
National Provider Identifier
1386070308
Registry record updated Jul 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5496-33 Issued in WI
Practice address
10 Tri Park Way
Appleton, WI 54914-1658
Phone
(920) 831-0070
NPI assigned
Sep 23, 2013
Last updated
Jul 20, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 5496-33 WI Primary

Addresses

Primary practice location

10 Tri Park Way
Appleton, WI 54914-1658

Mailing address

10 Tri Park Way
Appleton, WI 54914-1658
Phone (920) 831-0070

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
I20160205000102 WI Order and Referring Only - Nurse Practitioner 7719281120

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Milwaukee Vamc PastSince Aug 1, 2019 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1379894400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468972800000",
    "number": "1386070308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 TRI PARK WAY",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549141658",
            "telephone_number": "920-831-0070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 TRI PARK WAY",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549141658",
            "telephone_number": "920-831-0070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OCONNELL",
        "first_name": "MICHAEL",
        "middle_name": "ROBERT",
        "name_prefix": "Mr.",
        "credential": "APNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-09-23",
        "last_updated": "2016-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "5496-33",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Appleton, WI

Sources for this page

Verify at the official NPI Registry.