Active NPI
Diane Lynn Vanderlin, RN MSN APNP C
- Family Nurse Practitioner
- Green Bay, WI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 1309-33
- Practice address
- 725 S Webster Ave Ste 303
Green Bay, WI 54301-3539 - Phone
- (920) 431-5650
- Fax
- (920) 433-7400
- NPI assigned
- May 13, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 4704152987 | MI | |
| Family Nurse Practitioner | 363LF0000X | 1309-33 | WI | Primary |
Addresses
Primary practice location
725 S Webster Ave Ste 303
Green Bay, WI 54301-3539
Mailing address
PO Box 22487
Green Bay, WI 54305-2487
Phone (920) 445-7210
Other practice location 1
1305 West American Drive
Neenah, WI 54956-2883
Phone (920) 725-9373
Other practice location 2
820 Arbutus Ave
Oconto, WI 54153-2004
Phone (920) 835-1100
Other practice location 3
2820 Roosevelt Rd
Marinette, WI 54143-3834
Phone (715) 735-5225
Other practice location 4
212 E B St
Iron Mountain, MI 49801-3411
Phone (906) 776-9040
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 43830900 | Medicaid | WI | |
| 0240937 | Other | AMERICAN NURSES CREDENTIALING CENTER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI, MI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Science - Nursing, Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4704152987 | MI | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Oconto Hospital & Medical Center, Inc. | Current | Accepting new patients | |
| Bellin Memorial Hospital Inc | Current | Accepting new patients | |
| Bellin Memorial Hospital Inc | Current | Accepting new patients | |
| Oconto Hospital & Medical Center Inc | Current | Accepting new patients | |
| Oconto Hospital & Medical Center Inc | Current | Accepting new patients | |
| Bellin Memorial Hospital Inc | Current | Accepting new patients | |
| Bellin Memorial Hospital Inc | Current | Accepting new patients |
Locations
440 Woodward Ave
Iron Mountain, MI 49801
Phone (906) 776-9040
212 E B St
Iron Mountain, MI 49801
Phone (906) 774-2990
744 S Webster Ave
Green Bay, WI 54301
Phone (920) 433-6025
725 S Webster Ave
Ste 303
Green Bay, WI 54301
Phone (920) 431-5650
2820 Roosevelt Rd
Marinette, WI 54143
Phone (715) 330-6171
130 2nd St
Neenah, WI 54956
Phone (920) 729-2063
820 Arbutus Ave
Oconto, WI 54153
Phone (920) 835-1100
Organizations & group practices 7
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.
-
dba Bellin Health Algoma
- Rural Health Clinic/Center
- Algoma, WI
- NPI 1609838473
-
dba Emplify Health Oconto Hospital
- Critical Access Hospital
- Oconto, WI
- NPI 1356373302
-
dba Bellin Health Heart & Vascular Crystal Falls
- Cardiovascular Disease Physician
- Crystal Falls, MI
- NPI 1376649509
-
dba Bellin Health
- Family Medicine Physician
- Green Bay, WI
- NPI 1033172390
-
dba Bellin Health Infectious Disease Clinic
- Infectious Disease Physician
- Green Bay, WI
- NPI 1073063681
-
dba Bellin Health Suring
- Rural Health Clinic/Center
- Suring, WI
- NPI 1104418037
-
dba Bellin Health Oconto Falls
- Rural Health Clinic/Center
- Oconto Falls, WI
- NPI 1063038313
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147478400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1670544000000",
"number": "1407807563",
"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": "920-445-7210",
"fax_number": "920-445-7289"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "725 S WEBSTER AVE STE 303",
"city": "GREEN BAY",
"state": "WI",
"postal_code": "543013539",
"telephone_number": "920-431-5650",
"fax_number": "920-433-7400"
}
],
"practiceLocations": [
{
"address_1": "1305 West American Drive",
"address_purpose": "LOCATION",
"city": "Neenah",
"state": "WI",
"postal_code": "549562883",
"country_code": "US",
"telephone_number": "920-725-9373",
"fax_number": "920-720-7392",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "820 Arbutus Ave",
"address_purpose": "LOCATION",
"city": "Oconto",
"state": "WI",
"postal_code": "541532004",
"country_code": "US",
"telephone_number": "920-835-1100",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2820 Roosevelt Rd",
"address_purpose": "LOCATION",
"city": "Marinette",
"state": "WI",
"postal_code": "541433834",
"country_code": "US",
"telephone_number": "715-735-5225",
"fax_number": "715-735-5388",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "212 E B St",
"address_purpose": "LOCATION",
"city": "Iron Mountain",
"state": "MI",
"postal_code": "498013411",
"country_code": "US",
"telephone_number": "906-776-9040",
"fax_number": "906-774-5950",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "VANDERLIN",
"first_name": "DIANE",
"middle_name": "LYNN",
"name_prefix": "Mrs.",
"credential": "RN MSN APNP C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-13",
"last_updated": "2022-12-09",
"certification_date": "2022-12-09",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "MI",
"license": "4704152987",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "WI",
"license": "1309-33",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "43830900",
"state": "WI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERICAN NURSES CREDENTIALING CENTER",
"identifier": "0240937",
"state": null
}
],
"endpoints": [],
"other_names": []
}
Other providers in Green Bay, WI
- Paul David Vander Kelen, D.D.S.
- Katherine Mary Vander Zanden, APNP
- Katherine Vanderheiden, MAC
- Vanderleest Dental LLC
- Marcus James Vanderleest, DDS
- Luke Vandermause, PHARMD
- Patricia L Vandermause, LPC ,CSAC
- Margaret Innis Vandermeer, PT
- Joseph Martin Vandersteen, CRNA APNP
- Ryan Edward Vandervest, MS, LAT, CSCS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.