Individual provider Active NPI

Katie Vanbeckum, NP

  • Family Nurse Practitioner
  • Burlington, WI
National Provider Identifier
1609520378
Registry record updated Feb 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11356-33 Issued in WI
Practice address
248 McHenry St
Burlington, WI 53105-1828
Phone
(262) 767-6000
NPI assigned
Feb 10, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 11356-33 WI Primary

Addresses

Primary practice location

248 McHenry St
Burlington, WI 53105-1828

Mailing address

7750 Martha Cir
Waterford, WI 53185-2039
Phone (262) 220-1170

Other practice location 1

1401 Capital Ave
Plano, TX 75074-8160
Phone (214) 501-1310

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
I20220813000001 WI Practitioner - Nurse Practitioner 3870976509 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Acs Wounds LLC CurrentSince May 23, 2024 Accepting new patients

Locations

5439 Durand Ave
Ste 100
Mount Pleasant, WI 53406
Phone (262) 898-9000

5439 Durand Ave
Ste 102
Mount Pleasant, WI 53406

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1644451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644451200000",
    "number": "1609520378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7750 MARTHA CIR",
            "city": "WATERFORD",
            "state": "WI",
            "postal_code": "531852039",
            "telephone_number": "262-220-1170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "248 MCHENRY ST",
            "city": "BURLINGTON",
            "state": "WI",
            "postal_code": "531051828",
            "telephone_number": "262-767-6000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1401 Capital Ave",
            "address_purpose": "LOCATION",
            "city": "Plano",
            "state": "TX",
            "postal_code": "750748160",
            "country_code": "US",
            "telephone_number": "214-501-1310",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VANBECKUM",
        "first_name": "KATIE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-10",
        "last_updated": "2022-02-10",
        "certification_date": "2022-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "11356-33",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burlington, WI

Sources for this page

Verify at the official NPI Registry.