Individual provider Active NPI

Dylan A. Valentine, DNP

  • Nurse Practitioner
  • Green Bay, WI
National Provider Identifier
1386146082
Registry record updated Mar 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
8493 Issued in WI
Practice address
3263 Eaton Rd
Green Bay, WI 54311-6830
Phone
(920) 433-6700
Fax
(920) 433-6719
NPI assigned
Mar 8, 2018
Last updated
Mar 3, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 8493 WI Primary
Registered Nurse 163W00000X 201460-30 WI

Addresses

Primary practice location

3263 Eaton Rd
Green Bay, WI 54311-6830

Mailing address

PO Box 22487
Green Bay, WI 54305-2487
Phone (920) 445-7222

Other identifiers 1

IdentifierTypeStateIssuer
F06182203OtherAMERICAN ACADEMY OF NURSE PRACTITIONERS

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
I20180815002454 WI Practitioner - Nurse Practitioner 4183973720 Reassigns benefits to 2 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
Bellin Memorial Hospital IncGroup PAC ID 8820900749, 685 clinicians

Practice addresses (Care Compare)

3263 Eaton Rd
Green Bay, WI 54311-6830
Phone (920) 433-6700

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
201460-30WIMDRegistered Nurse
8493WIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Bellin Memorial Hospital Inc CurrentSince Aug 24, 2020 Accepting new patients
Oconto Hospital & Medical Center Inc CurrentSince Jul 1, 2024 Accepting new patients
Oconto Hospital & Medical Center Inc CurrentSince Jul 1, 2024 Accepting new patients
Bellin Memorial Hospital Inc Current Accepting new patients
Bellin Memorial Hospital Inc CurrentSince Aug 24, 2020 Accepting new patients
Bellin Memorial Hospital Inc Past Accepting new patients

Locations

3263 Eaton Rd
Green Bay, WI 54311
Phone (920) 433-6000

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

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

2820 Roosevelt Rd
Marinette, WI 54143
Phone (715) 330-6171

820 Arbutus Ave
Oconto, WI 54153
Phone (920) 835-1100

Interoperability endpoints

  • Direct secure messaging: dvalentine42788@direct.thedacare.org
  • Direct secure messaging: dvalentine926166@direct.emplifyhealth.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1520467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646265600000",
    "number": "1386146082",
    "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": "920-445-7222",
            "fax_number": "920-445-7289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3263 EATON RD",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543116830",
            "telephone_number": "920-433-6700",
            "fax_number": "920-433-6719"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALENTINE",
        "first_name": "DYLAN",
        "middle_name": "A.",
        "credential": "DNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-08",
        "last_updated": "2022-03-03",
        "certification_date": "2022-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "8493",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WI",
            "license": "201460-30",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICAN ACADEMY OF NURSE PRACTITIONERS",
            "identifier": "F06182203",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Green Bay, WI

Sources for this page

Verify at the official NPI Registry.