Individual provider Active NPI

Kirsten Cull, NP

  • Family Nurse Practitioner
  • Pewaukee, WI
National Provider Identifier
1568020105
Registry record updated Oct 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
9346 Issued in WI
Practice address
N21W28337 Beach Rd
Pewaukee, WI 53072-5136
Phone
(262) 391-7067
NPI assigned
May 29, 2019
Last updated
Oct 20, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 9346 WI Primary
Family Nurse Practitioner 363LF0000X 223695 WI

Addresses

Primary practice location

N21W28337 Beach Rd
Pewaukee, WI 53072-5136

Mailing address

N21W28337 Beach Rd
Pewaukee, WI 53072-5136
Phone (262) 391-7067

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
I20191212003103 WI Practitioner - Nurse Practitioner 4688007180 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prohealth Medical Group IncGroup PAC ID 3476465188, 475 clinicians

Practice addresses (Care Compare)

195 Discovery Dr
Brookfield, WI 53045-2862
Phone (262) 928-7100

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
223695WIMDFamily Nurse Practitioner
9346WIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Prohealth Medical Group Inc. CurrentSince Nov 1, 2020 Accepting new patients
Prohealth Medical Group Inc CurrentSince Nov 1, 2020 Accepting new patients
Emergency Medical Associates LLP CurrentSince Dec 18, 2019 Accepting new patients
Prohealth Medical Group Inc Past Accepting new patients

Locations

195 Discovery Dr
Brookfield, WI 53045
Phone (262) 513-7100

2750 Golf Rd
Delafield, WI 53018
Phone (262) 928-4900

240 Maple Ave
Mukwonago, WI 53149
Phone (262) 928-1900

240 Maple Ave
Ste 2240
Mukwonago, WI 53149

13900 W National Ave
New Berlin, WI 53151
Phone (262) 928-4500

1185 Corporate Center Dr
Ste 175
Oconomowoc, WI 53066
Phone (262) 928-6236

791 Summit Ave
Summit, WI 53066
Phone (262) 569-0251

109 Air Park Dr
Watertown, WI 53094
Phone (262) 928-5100

1011 Spring City Dr
Waukesha, WI 53186
Phone (262) 925-0370

2130 Big Bend Rd
Waukesha, WI 53189
Phone (262) 513-7555

725 American Ave
Waukesha, WI 53188
Phone (262) 544-2011

725 American Ave
#5
Waukesha, WI 53188
Phone (262) 928-2475

725 American Ave
Ste 5
Waukesha, WI 53188
Phone (262) 544-2384

N14W23900 Stone Ridge Dr
Waukesha, WI 53188
Phone (262) 549-3030

N16W24131 Riverwood Dr
Waukesha, WI 53188
Phone (262) 696-0696

N16W24131 Riverwood Dr
Ste 2200B
Waukesha, WI 53188
Phone (262) 696-0765

N17W24100 Riverwood Dr
Waukesha, WI 53188
Phone (262) 820-3093

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1559088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603152000000",
    "number": "1568020105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "N21W28337 BEACH RD",
            "city": "PEWAUKEE",
            "state": "WI",
            "postal_code": "530725136",
            "telephone_number": "262-391-7067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "N21W28337 BEACH RD",
            "city": "PEWAUKEE",
            "state": "WI",
            "postal_code": "530725136",
            "telephone_number": "262-391-7067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CULL",
        "first_name": "KIRSTEN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-29",
        "last_updated": "2020-10-20",
        "certification_date": "2020-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "9346",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "223695",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pewaukee, WI

Sources for this page

Verify at the official NPI Registry.