Individual provider Active NPI

Laura McKinnis, N.P.

  • Nurse Practitioner
  • Grafton, WI
National Provider Identifier
1497931943
Registry record updated May 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
3279-33 Issued in WI
Practice address
1505 Wisconsin Ave Ste 150
Grafton, WI 53024-2075
Phone
(262) 421-8961
NPI assigned
Jan 15, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Clinical Nurse Specialist 364SE0003X 3279-033 WI
Nurse Practitioner 363L00000X 3279-33 WI Primary

Addresses

Primary practice location

1505 Wisconsin Ave Ste 150
Grafton, WI 53024-2075

Mailing address

1505 Wisconsin Ave Ste 150
Grafton, WI 53024-2075
Phone (262) 421-8961

Other identifiers 2

IdentifierTypeStateIssuer
N/AOtherWIN/A
360599200MedicaidWI

Other names 1

  • Laura A Okeefe Former name

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
I20080222000346 WI Practitioner - Nurse Practitioner 4789768235 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Oasis Health Care LLCGroup PAC ID 1456766815, 2 clinicians

Practice addresses (Care Compare)

1505 Wisconsin Ave
Suite 150
Grafton, WI 53024-2075
Phone (262) 421-8961

Hospital & facility affiliations

  • Northwestern Medicine Central Dupage Hospital Hospital, Winfield, IL, CCN 140242

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
3279-033WIMDEmergency Clinical Nurse Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
United Occupational Medicine and Walk in Services, LLC Nurse Practitioner Past Accepting new patients
Health Dynamics, LLC Nurse Practitioner Past Accepting new patients
Ihc-Libertyville Emergency Physicians, LLC Past Accepting new patients

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 2

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": "1200355200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683676800000",
    "number": "1497931943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1505 WISCONSIN AVE STE 150",
            "city": "GRAFTON",
            "state": "WI",
            "postal_code": "530242075",
            "telephone_number": "262-421-8961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1505 WISCONSIN AVE STE 150",
            "city": "GRAFTON",
            "state": "WI",
            "postal_code": "530242075",
            "telephone_number": "262-421-8961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKINNIS",
        "first_name": "LAURA",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-15",
        "last_updated": "2023-05-10",
        "certification_date": "2023-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SE0003X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Emergency",
            "state": "WI",
            "license": "3279-033",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "3279-33",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "N/A",
            "identifier": "N/A",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "360599200",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAURA",
            "last_name": "OKEEFE",
            "middle_name": "A",
            "credential": "N.P.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Grafton, WI

Sources for this page

Verify at the official NPI Registry.