Active NPI
Kimberly Kate Mizelle, APNP
- Family Nurse Practitioner
- Lake Geneva, WI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 179925-30
- Practice address
- N2950 State Road 67
Lake Geneva, WI 53147-2655 - Phone
- (262) 245-0535
- Fax
- (262) 245-4627
- NPI assigned
- Aug 18, 2025
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 179925-30 | WI | Primary |
Addresses
Primary practice location
N2950 State Road 67
Lake Geneva, WI 53147-2655
Mailing address
225 Grace St
Walworth, WI 53184-9636
Phone (262) 745-9353
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2025
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Mercy Health System Corporation
Practice addresses (Care Compare)
1000 Mineral Point Ave
Janesville, WI 53548-2940
Phone (608) 756-6000
Hospital & facility affiliations
- Mercy Walworth Hospital & Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 179925-30 | WI | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mercy Health System Corporation | Current | Accepting new patients | |
| Mercy Health System Corporation | Current | Accepting new patients | |
| Mercy Health System Corporation | Current | Accepting new patients | |
| Mercy Health System Corporation | Past | Accepting new patients |
Locations
29624 Network Pl
Chicago, IL 60673
Phone (608) 741-7652
1000 Mineral Point Ave
Janesville, WI 53548
Phone (608) 261-6868
N2950 State Road 67
Lake Geneva, WI 53147
Phone (262) 245-0535
Interoperability endpoints
- kmizelle59512@direct.mhemail.org
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.
-
- Multi-Specialty Clinic/Center
- Janesville, WI
- NPI 1598718603
-
- Critical Access Hospital
- Lake Geneva, WI
- NPI 1699728550
-
- General Acute Care Hospital
- Janesville, WI
- NPI 1093768962
-
- Prosthetic/Orthotic Supplier
- Lake Geneva, WI
- NPI 1710124698
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Critical Access Hospital
- Lake Geneva, WI
- NPI 1699728550
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1755475200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1760486400000",
"number": "1497632103",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "225 GRACE ST",
"city": "WALWORTH",
"state": "WI",
"postal_code": "531849636",
"telephone_number": "262-745-9353"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "N2950 STATE ROAD 67",
"city": "LAKE GENEVA",
"state": "WI",
"postal_code": "531472655",
"telephone_number": "262-245-0535",
"fax_number": "262-245-4627"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MIZELLE",
"first_name": "KIMBERLY",
"middle_name": "KATE",
"credential": "APNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-08-18",
"last_updated": "2025-10-15",
"certification_date": "2025-10-15",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "WI",
"license": "179925-30",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Lake Geneva, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2025; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.