Individual provider Active NPI

Lynn B Kohlmeier, M.D.

  • Pediatrics Physician
  • Neenah, WI
National Provider Identifier
1528053626
Registry record updated Mar 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
31381 Issued in WI
Practice address
130 2ND St
Neenah, WI 54956-2883
Phone
(920) 969-7906
Fax
(920) 969-7979
NPI assigned
Sep 14, 2005
Last updated
Mar 30, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 31381 WI Primary

Addresses

Primary practice location

130 2ND St
Neenah, WI 54956-2883

Mailing address

849 Whisper Falls LN
Menasha, WI 54952-9503
Phone (262) 227-0194

Other identifiers 1

IdentifierTypeStateIssuer
1528053626MedicaidWI

Other names 1

  • Lynn B Ruechel 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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080820000259 WI Practitioner - Pediatric Medicine 1153496575 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
31381WIMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Thedacare, Incorporated CurrentSince Mar 31, 2024 Accepting new patients
Ascension NE Wisconsin, Inc Current Accepting new patients
Mercy Health System Corporation CurrentSince Oct 1, 2012 Accepting new patients
Mercy Health System Corporation CurrentSince Oct 1, 2012 Accepting new patients
Ascension NE Wisconsin, Inc CurrentSince Sep 21, 2016 Accepting new patients
Aurora Medical Group, Inc. Past Accepting new patients

Locations

29624 Network Pl
Chicago, IL 60673
Phone (608) 741-7652

1506 S Oneida St
Appleton, WI 54915
Phone (920) 730-4950

1818 N Meade St
Appleton, WI 54911
Phone (920) 731-4101

4480 W Spencer St
Appleton, WI 54914
Phone (920) 738-4800

611 Sherman Ave E
Fort Atkinson, WI 53538
Phone (920) 563-6667

1000 Mineral Point Ave
Janesville, WI 53548
Phone (608) 261-6868

130 2nd St
Neenah, WI 54956
Phone (920) 729-2063

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1126656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680134400000",
    "number": "1528053626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "849 WHISPER FALLS LN",
            "city": "MENASHA",
            "state": "WI",
            "postal_code": "549529503",
            "telephone_number": "262-227-0194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 2ND ST",
            "city": "NEENAH",
            "state": "WI",
            "postal_code": "549562883",
            "telephone_number": "920-969-7906",
            "fax_number": "920-969-7979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOHLMEIER",
        "first_name": "LYNN",
        "middle_name": "B",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-14",
        "last_updated": "2023-03-30",
        "certification_date": "2023-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WI",
            "license": "31381",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1528053626",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LYNN",
            "last_name": "RUECHEL",
            "middle_name": "B",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Neenah, WI

Sources for this page

Verify at the official NPI Registry.