Vonda B Dahms, APNP
Individual provider Active NPI Adult Health Nurse Practitioner · Menasha, WI
NPI 1477824282 · NPPES record last updated Apr 30, 2015
Key facts
- NPI
- 1477824282
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Adult Health Nurse Practitioner 363LA2200X
- License
- 4752-33 (WI)
- Practice address
- 1814 Appleton Rd
Menasha, WI 54952-1110 - Phone
- (920) 731-7445
- Fax
- (920) 731-7490
- NPI assigned
- Jan 25, 2012
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 14
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2011
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Prohealth Medical Group Inc
Practice addresses (Care Compare)
725 American Ave
Waukesha, WI 53188-5031
Phone (262) 928-1000
Hospital & facility affiliations
- Waukesha Memorial Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150403000720 | WI | Practitioner - Nurse Practitioner | 8022259043 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Prohealth Medical Group Inc. | Current |
Accepting new patients | |
| Prohealth Medical Group Inc | Current |
Accepting new patients | |
| Prohealth Medical Group Inc | Past | Accepting new patients |
Locations
N14W23900 Stone Ridge Dr
Waukesha, WI 53188
Phone (262) 549-3030
725 American Ave
Waukesha, WI 53188
Phone (262) 544-2011
N17W24100 Riverwood Dr
Waukesha, WI 53188
Phone (262) 820-3093
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Health Nurse Practitioner | 363LA2200X | 4752-33 | WI | Yes |
Addresses
Primary practice location
1814 Appleton Rd
Menasha, WI 54952-1110
Mailing address
5337 W Grande Market Dr
Appleton, WI 54913-8442
Phone (920) 731-7445
NPI Registry JSON
{
"created_epoch": "1327449600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1430352000000",
"number": "1477824282",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5337 W GRANDE MARKET DR",
"city": "APPLETON",
"state": "WI",
"postal_code": "549138442",
"telephone_number": "920-731-7445",
"fax_number": "920-882-2946"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1814 APPLETON RD",
"city": "MENASHA",
"state": "WI",
"postal_code": "549521110",
"telephone_number": "920-731-7445",
"fax_number": "920-731-7490"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAHMS",
"first_name": "VONDA",
"middle_name": "B",
"credential": "APNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-01-25",
"last_updated": "2015-04-30",
"status": "A"
},
"taxonomies": [
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "WI",
"license": "4752-33",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Menasha, WI
- Sharon Louise Crowe
- James Cruthers
- Cultura Counseling LLC
- Matthew William Czerwan
- Kortney Dahm
- Kathi Danke
- Olivia Davel
- Shanna Headley Davis
- Catalina De Luna
- David Arthur De Pas
All providers in Menasha, WI · Adult Health Nurse Practitioner in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 30, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.