Individual provider Active NPI

Colten Peter Thewis, FNP

  • Family Nurse Practitioner
  • Ashland, WI
National Provider Identifier
1457096810
Registry record updated May 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11927-33 Issued in WI
Practice address
1615 Maple LN
Ashland, WI 54806-3689
Phone
(715) 685-5500
NPI assigned
Apr 30, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 5, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 11927-33 WI Primary

Addresses

Primary practice location

1615 Maple LN
Ashland, WI 54806-3689

Mailing address

1615 Maple LN
Ashland, WI 54806-3689
Phone (715) 685-5240

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
I20221216001833 WI Practitioner - Physical Medicine and Rehabilitation 4587033311 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

11040 N State Rd
Suite 77
Hayward, WI 54843

1615 Maple LN
Ashland, WI 54806-3626

1615 Maple LN
Ashland, WI 54806-3689

Hospital & facility affiliations

  • Tamarack Health Ashland Medical Center Hospital, Ashland, WI, CCN 521359

Merit-based Incentive Payment System (MIPS)

Final score
86.19 of 100Reported as group
Quality
74.89
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11927WIMDInterpreter
11927-33WIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Medical Center Inc CurrentSince Jul 29, 2022 Accepting new patients
Memorial Medical Center Inc CurrentSince Jul 29, 2022 Accepting new patients

Locations

1615 Maple Ln
Ashland, WI 54806
Phone (715) 682-4563

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": "1651276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651708800000",
    "number": "1457096810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1615 MAPLE LN",
            "city": "ASHLAND",
            "state": "WI",
            "postal_code": "548063689",
            "telephone_number": "715-685-5240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1615 MAPLE LN",
            "city": "ASHLAND",
            "state": "WI",
            "postal_code": "548063689",
            "telephone_number": "715-685-5500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THEWIS",
        "first_name": "COLTEN",
        "middle_name": "PETER",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-04-30",
        "last_updated": "2022-05-05",
        "certification_date": "2022-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "11927-33",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ashland, WI

Sources for this page

Verify at the official NPI Registry.