Individual provider Active NPI

Kelsey C Risner, PA-C

  • Physician Assistant
  • Green Bay, WI
National Provider Identifier
1467933788
Registry record updated Sep 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
4503-23 Issued in WI
Practice address
744 S Webster Ave
Green Bay, WI 54301-3505
Phone
(920) 433-3640
NPI assigned
Aug 24, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 4503-23 WI Primary

Addresses

Primary practice location

744 S Webster Ave
Green Bay, WI 54301-3505

Mailing address

744 S Webster Ave
Green Bay, WI 54301-3505
Phone (920) 433-3640

Other names 1

  • Kelsey C Reed Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kreed156898@ewd.direct.hshs.org Direct

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
I20181008003436 WI Practitioner - Physician Assistant 1355693078 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bellin Memorial Hospital IncGroup PAC ID 8820900749, 685 clinicians
Oconto Hospital and Medical Center IncGroup PAC ID 2163461781, 217 clinicians

Practice addresses (Care Compare)

2020 S Webster Ave
Accounting
Green Bay, WI 54301-3505

2820 Roosevelt Rd
Marinette, WI 54143-3834
Phone (715) 735-5225

744 S Webster Ave
Green Bay, WI 54301-3505

820 Arbutus Ave
Oconto, WI 54153-2004
Phone (920) 835-1100

Hospital & facility affiliations

  • Bellin Memorial Hospital Hospital, Green Bay, WI, CCN 520049
  • Door County Medical Center Hospital, Sturgeon Bay, WI, CCN 521358

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
4503-23WIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Door County Memorial Hospital CurrentSince Jul 2, 2019 Accepting new patients
Door County Memorial Hospital CurrentSince Jul 2, 2019 Accepting new patients
Bellin Memorial Hospital Inc CurrentSince Apr 5, 2022 Accepting new patients
Bellin Memorial Hospital Inc CurrentSince Apr 5, 2022 Accepting new patients
Oconto Hospital & Medical Center Inc CurrentSince Apr 5, 2022 Accepting new patients
Oconto Hospital & Medical Center Inc CurrentSince Apr 5, 2022 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients
Bellin Memorial Hospital Inc Past Accepting new patients
Oconto Hospital & Medical Center Inc Past Accepting new patients

Locations

744 S Webster Ave
Green Bay, WI 54301
Phone (920) 433-6025

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

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

2820 Roosevelt Rd
Marinette, WI 54143
Phone (715) 330-6171

820 Arbutus Ave
Oconto, WI 54153
Phone (920) 835-1100

323 S 18th Ave
Sturgeon Bay, WI 54235
Phone (920) 743-5566

Interoperability endpoints

  • Direct secure messaging: krisner925662@direct.emplifyhealth.org
  • Direct secure messaging: kreed320706@direct.thedacare.org
  • Direct secure messaging: kelsey.reed@direct.dcmedical.org

Organizations & group practices 10

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 3

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": "1535068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695340800000",
    "number": "1467933788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "744 S WEBSTER AVE",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543013505",
            "telephone_number": "920-433-3640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "744 S WEBSTER AVE",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543013505",
            "telephone_number": "920-433-3640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RISNER",
        "first_name": "KELSEY",
        "middle_name": "C",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-24",
        "last_updated": "2023-09-22",
        "certification_date": "2023-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "4503-23",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kreed156898@ewd.direct.hshs.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "835 S Van Buren St",
            "city": "Green Bay",
            "state": "WI",
            "country_code": "US",
            "postal_code": "543013526",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KELSEY",
            "last_name": "REED",
            "middle_name": "C",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Green Bay, WI

Sources for this page

Verify at the official NPI Registry.