Individual provider Active NPI

Allison Kay Fendrick, FNP-C

  • Nurse Practitioner
  • Madison, WI
National Provider Identifier
1396568762
Registry record updated Nov 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
16146-33 Issued in WI
Practice address
1705 Hoffman St
Madison, WI 53704-2510
Phone
(608) 828-4853
NPI assigned
Nov 5, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 16146-33 WI Primary

Addresses

Primary practice location

1705 Hoffman St
Madison, WI 53704-2510

Mailing address

1011 Summit Ave Apt 10
Stoughton, WI 53589-2582
Phone (608) 225-1484

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
I20241203002117 WI Practitioner - Nurse Practitioner 4789119553 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Group Health Cooperative of South Central WisconsinGroup PAC ID 3870489586, 233 clinicians

Practice addresses (Care Compare)

3051 Cahill Main
Fitchburg, WI 53711-7109
Phone (608) 661-7200

5249 E Terrace Dr
Madison, WI 53718-8339
Phone (608) 222-9777

675 W Washington Ave
Madison, WI 53703-2637
Phone (608) 257-9700

8202 Excelsior Dr
Madison, WI 53717-1906
Phone (608) 831-1766

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
16146-33WIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Group Health Cooperative of South Central Wi - Madison College CurrentSince Nov 24, 2024 Accepting new patients
Group Health Cooperative of South Central Wisconsin CurrentSince Nov 4, 2024 Accepting new patients

Locations

1705 Hoffman St
Madison, WI 53704
Phone (608) 441-3220

675 W Washington Ave
Madison, WI 53703
Phone (608) 257-5178

8202 Excelsior Dr
Madison, WI 53717
Phone (608) 831-1766

1265 John Q Hammons Dr
Madison, WI 53717

Organizations & group practices 2

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.

Hospital & facility affiliations 1

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": "1730764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732060800000",
    "number": "1396568762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1011 SUMMIT AVE APT 10",
            "city": "STOUGHTON",
            "state": "WI",
            "postal_code": "535892582",
            "telephone_number": "608-225-1484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1705 HOFFMAN ST",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537042510",
            "telephone_number": "608-828-4853"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FENDRICK",
        "first_name": "ALLISON",
        "middle_name": "KAY",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-11-05",
        "last_updated": "2024-11-20",
        "certification_date": "2024-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "16146-33",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

Verify at the official NPI Registry.