Individual provider Active NPI

Ashley Marie Weiner

  • Family Nurse Practitioner
  • Green Bay, WI
National Provider Identifier
1548769383
Registry record updated May 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
8248-33 Issued in WI
Practice address
2020 Riverside Dr Ste 200
Green Bay, WI 54301-2300
Phone
(920) 433-9920
Fax
(920) 433-9927
NPI assigned
Feb 7, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 11, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 159138 WI
Family Nurse Practitioner 363LF0000X 8248-33 WI Primary

Addresses

Primary practice location

2020 Riverside Dr Ste 200
Green Bay, WI 54301-2300

Mailing address

PO Box 22487
Green Bay, WI 54305-2487
Phone (920) 445-7222

Other practice location 1

226 Bornemann St
Green Bay, WI 54302-3502
Phone (920) 264-6545

Other practice location 2

3415 Custer St
Manitowoc, WI 54220-4324
Phone (920) 652-9310

Other identifiers 1

IdentifierTypeStateIssuer
F01180811OtherAMERICAN ACADEMY OF NURSE PRACTITIONERS

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
I20250227003980 WI Order and Referring Only - Nurse Practitioner 2769747468

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
159138WIMDRegistered Nurse
8248-33WIMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1517961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589155200000",
    "number": "1548769383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 22487",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543052487",
            "telephone_number": "920-445-7222",
            "fax_number": "920-445-7289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 RIVERSIDE DR STE 200",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543012300",
            "telephone_number": "920-433-9920",
            "fax_number": "920-433-9927"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "226 Bornemann St",
            "address_purpose": "LOCATION",
            "city": "Green Bay",
            "state": "WI",
            "postal_code": "543023502",
            "country_code": "US",
            "telephone_number": "920-264-6545",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3415 Custer St",
            "address_purpose": "LOCATION",
            "city": "Manitowoc",
            "state": "WI",
            "postal_code": "542204324",
            "country_code": "US",
            "telephone_number": "920-652-9310",
            "fax_number": "920-652-9316",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WEINER",
        "first_name": "ASHLEY",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-07",
        "last_updated": "2020-05-11",
        "certification_date": "2020-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WI",
            "license": "159138",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "8248-33",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICAN ACADEMY OF NURSE PRACTITIONERS",
            "identifier": "F01180811",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Green Bay, WI

Sources for this page

Verify at the official NPI Registry.