NPIMap

Individual provider Active NPI

Lisa May Fonder, FNP-C, APNP

  • Family Nurse Practitioner
  • Oconto Falls, WI
National Provider Identifier
1457639486
Registry record updated May 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4470-33 Issued in WI
Practice address
835 S Main St Ste 1
Oconto Falls, WI 54154-1282
Phone
(920) 496-4700
NPI assigned
Jul 25, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 3, 2023

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 4470-33 WI Primary

Addresses

Primary practice location

835 S Main St Ste 1
Oconto Falls, WI 54154-1282

Mailing address

PO Box 19070
Green Bay, WI 54307-9070
Phone (920) 496-4700

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
I20110824000794 WI Practitioner - Nurse Practitioner 3476723727 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Clare Memorial Hospital, IncGroup PAC ID 0446211395, 62 clinicians

Practice addresses (Care Compare)

3021 Voyager Dr
Green Bay, WI 54311-8303
Phone (920) 496-4700

835 S Main St
Oconto Falls, WI 54154-1282

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.81 of 100Reported as apm
Quality
85.98
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4470-33WIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St Vincent Hospital-Hospital Sisters-Third Order of St Francis CurrentSince Aug 8, 2011 Accepting new patients
St Vincent Hospital-Hospital Sisters-Third Order of St Francis CurrentSince Aug 8, 2011 Accepting new patients
St Clare Memorial Hospital, Inc CurrentSince Mar 1, 2019 Accepting new patients
St. Clare Memorial Hospital, Inc CurrentSince Mar 1, 2019 Accepting new patients

Locations

3021 Voyager Dr
Green Bay, WI 54311
Phone (920) 431-1810

835 S Van Buren St
Green Bay, WI 54301
Phone (888) 901-7246

855 S Main St
Ste 1
Oconto Falls, WI 54154
Phone (920) 846-8187

835 S Main St
Ste 1
Oconto Falls, WI 54154
Phone (920) 846-4864

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 9

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": "1311552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683072000000",
    "number": "1457639486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19070",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543079070",
            "telephone_number": "920-496-4700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "835 S MAIN ST STE 1",
            "city": "OCONTO FALLS",
            "state": "WI",
            "postal_code": "541541282",
            "telephone_number": "920-496-4700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FONDER",
        "first_name": "LISA",
        "middle_name": "MAY",
        "name_prefix": "Mrs.",
        "credential": "FNP-C, APNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-25",
        "last_updated": "2023-05-03",
        "certification_date": "2023-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "4470-33",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oconto Falls, WI

Sources for this page

Verify at the official NPI Registry.