Individual provider Active NPI

Mary Nell Kirsch Rupp, MD

  • Emergency Medicine Physician
  • Green Bay, WI
National Provider Identifier
1407077282
Registry record updated May 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
57547 Issued in WI
Practice address
2253 W Mason St
Green Bay, WI 54303-4706
Phone
(920) 327-7250
Fax
(920) 327-7249
NPI assigned
May 1, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 19, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 2007010575 MO
Emergency Medicine Physician 207P00000X 57547 WI Primary
Emergency Medicine Physician 207P00000X 200800576 MO

Addresses

Primary practice location

2253 W Mason St
Green Bay, WI 54303-4706

Mailing address

1035 Kepler Dr
Green Bay, WI 54311-8320
Phone (920) 490-9046

Other names 1

  • Dr. Mary Nell Kirsch 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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130216000063 WI Practitioner - Emergency Medicine 8628164027 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Medical College of Wisconsin, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Baycare Aurora LLCGroup PAC ID 0244130557, 197 clinicians

Practice addresses (Care Compare)

2253 W Mason St
Green Bay, WI 54303-4706
Phone (920) 327-7246

Hospital & facility affiliations

  • Aurora Baycare Medical Ctr Hospital, Green Bay, WI, CCN 520193

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
200800576MOMDEmergency Medicine Physician
57547WIMDEmergency Medicine Physician
576NCMDClinical Nurse Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Baycare Clinic LLP CurrentSince Feb 1, 2020 Accepting new patients
Baycare Clinic LLP Emergency Medicine CurrentSince Feb 1, 2020 Accepting new patients
Baycare Aurora, LLC CurrentSince Jan 23, 2020 Accepting new patients
Mercy Hospital South Emergency Medicine Past Accepting new patients

Locations

2253 W Mason St
Green Bay, WI 54303
Phone (920) 327-7000

2845 Greenbrier Rd
Green Bay, WI 54311
Phone (920) 288-3388

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

2581 Development Dr
Green Bay, WI 54311
Phone (920) 347-0400

1035 Kepler Dr
Green Bay, WI 54311

Organizations & group practices 4

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": "1177977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779148800000",
    "number": "1407077282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1035 KEPLER DR",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543118320",
            "telephone_number": "920-490-9046",
            "fax_number": "920-405-8005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2253 W MASON ST",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543034706",
            "telephone_number": "920-327-7250",
            "fax_number": "920-327-7249"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUPP",
        "first_name": "MARY",
        "middle_name": "NELL KIRSCH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-01",
        "last_updated": "2026-05-19",
        "certification_date": "2026-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MO",
            "license": "2007010575",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WI",
            "license": "57547",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MO",
            "license": "200800576",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "KIRSCH",
            "middle_name": "NELL",
            "prefix": "DR.",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Green Bay, WI

Sources for this page

Verify at the official NPI Registry.