NPIMap

Individual provider Active NPI

Kimberly Radtke, APNP

  • Nurse Practitioner
  • Weston, WI
National Provider Identifier
1407148042
Registry record updated Jun 5, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
4101 Issued in WI
Practice address
3400 Ministry Pkwy
Weston, WI 54476-5220
Phone
(715) 393-3000
NPI assigned
May 13, 2011
Last updated
Jun 5, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2015

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 4101 WI Primary
Gerontology Nurse Practitioner 363LG0600X 4101 WI
Adult Health Clinical Nurse Specialist 364SA2200X 4101-033 WI

Addresses

Primary practice location

3400 Ministry Pkwy
Weston, WI 54476-5220

Mailing address

3400 Ministry Pkwy
Weston, WI 54476-5220
Phone (715) 393-3000

Other identifiers 2

IdentifierTypeStateIssuer
4101OtherWIAPNP LIC
128613OtherWIRN LICENSE

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
I20141006001155 WI Practitioner - Nurse Practitioner 3971723487 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2251 N Shore Dr
Rhinelander, WI 54501-6710
Phone (715) 361-2000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.84 of 100Reported as group
Quality
86.21
Promoting interoperability
100
Improvement activities
40
Cost
73.25

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4101WIMDPhysical Medicine & Rehabilitation Physician
4101-033WIMDAdult Health Clinical Nurse Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
The Howard Young Medical Center, Inc. CurrentSince Mar 12, 2023 Accepting new patients
Aspirus Rhinelander & Tomahawk Hospitals & Clinics, Inc. CurrentSince Nov 19, 2017 Accepting new patients
The Howard Young Medical Center, Inc. Current Accepting new patients
Aspirus Stevens Point Hospital & Clinics, Inc. CurrentSince Feb 1, 2016 Accepting new patients
Aspirus Rhinelander & Tomahawk Hospitals & Clinics, Inc. CurrentSince Nov 19, 2017 Accepting new patients
Aspirus Stevens Point Hospital & Clinics, Inc. CurrentSince Feb 1, 2016 Accepting new patients

Locations

29980 Network Pl
Chicago, IL 60673

601 S Center Ave
Merrill, WI 54452
Phone (715) 536-5511

1020 Kabel Ave
Rhinelander, WI 54501
Phone (715) 361-2805

2251 N Shore Dr
Ste 100
Rhinelander, WI 54501
Phone (715) 361-3000

1120 Pine St
Stanley, WI 54768
Phone (715) 644-5530

824 Illinois Ave
Stevens Point, WI 54481
Phone (715) 342-7500

900 Illinois Ave
Stevens Point, WI 54481
Phone (715) 342-7500

401 W Mohawk Dr
Ste 100
Tomahawk, WI 54487
Phone (715) 453-7700

3400 Ministry Pkwy
Weston, WI 54476
Phone (715) 393-1000

240 Maple St
Woodruff, WI 54568
Phone (715) 356-8000

Interoperability endpoints

  • Direct secure messaging: kradtke169680@direct.aspirus.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 34

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

View all 34

NPI Registry JSON

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

{
    "created_epoch": "1305244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433462400000",
    "number": "1407148042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 MINISTRY PKWY",
            "city": "WESTON",
            "state": "WI",
            "postal_code": "544765220",
            "telephone_number": "715-393-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 MINISTRY PKWY",
            "city": "WESTON",
            "state": "WI",
            "postal_code": "544765220",
            "telephone_number": "715-393-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RADTKE",
        "first_name": "KIMBERLY",
        "credential": "APNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-13",
        "last_updated": "2015-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "4101",
            "primary": true
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "WI",
            "license": "4101",
            "primary": false
        },
        {
            "code": "364SA2200X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Adult Health",
            "state": "WI",
            "license": "4101-033",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "APNP LIC",
            "identifier": "4101",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RN LICENSE",
            "identifier": "128613",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Weston, WI

Sources for this page

Verify at the official NPI Registry.