NPIMap

Individual provider Active NPI

Kimberly Hatch, DNP

  • Nurse Practitioner
  • Medford, WI
National Provider Identifier
1619484532
Registry record updated Jul 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
8035 Issued in WI
Practice address
135 S Gibson St
Medford, WI 54451-1622
Phone
(715) 748-8100
NPI assigned
Dec 30, 2017
Last updated
Jul 20, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 20, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 8035 WI Primary

Addresses

Primary practice location

135 S Gibson St
Medford, WI 54451-1622

Mailing address

615 South St
Deforest, WI 53532-1464

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180724001367 WI Practitioner - Nurse Practitioner 3870840754 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aspirus Medford Hospital and Clinics IncGroup PAC ID 5799688602, shared by 9 NPIs, 126 clinicians
Divine Savior Healthcare IncGroup PAC ID 5799684007, 135 clinicians

Practice addresses (Care Compare)

135 S Gibson St
Medford, WI 54451-1622
Phone (715) 748-8100

2817 New Pinery Rd
Portage, WI 53901-9240
Phone (608) 742-4131

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.7 of 100Reported as group
Quality
91.14
Promoting interoperability
100
Improvement activities
40
Cost
77.5

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
97.16
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
8035WIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Aspirus Stanley Hospital & Clinics, Inc. CurrentSince Jul 11, 2023 Accepting new patients
Divine Savior Healthcare, Inc. Emergency Medicine CurrentSince Aug 1, 2020 Accepting new patients
Aspirus Medford Hospital & Clinics, Inc. Current Accepting new patients
Divine Savior Healthcare, Inc. CurrentSince Aug 1, 2020 Accepting new patients
Aspirus Medford Hospital & Clinics, Inc. CurrentSince Apr 6, 2021 Accepting new patients
Aspirus Medford Hospital & Clinics, Inc. CurrentSince Apr 6, 2021 Accepting new patients
Aspirus Stanley Hospital & Clinics, Inc CurrentSince Jul 11, 2023 Accepting new patients
Aspirus Medford Hospital & Clinics, Inc. Current Accepting new patients

Locations

29980 Network Pl
Chicago, IL 60673

135 S Gibson St
Medford, WI 54451
Phone (715) 748-8100

143 S Gibson St
Medford, WI 54451
Phone (715) 748-2121

2817 New Pinery Rd
Portage, WI 53901
Phone (608) 745-4598

1120 Pine St
Stanley, WI 54768
Phone (715) 644-5530

Organizations & group practices 8

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 9

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": "1514592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689811200000",
    "number": "1619484532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 SOUTH ST",
            "city": "DEFOREST",
            "state": "WI",
            "postal_code": "535321464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 S GIBSON ST",
            "city": "MEDFORD",
            "state": "WI",
            "postal_code": "544511622",
            "telephone_number": "715-748-8100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HATCH",
        "first_name": "KIMBERLY",
        "credential": "DNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-12-30",
        "last_updated": "2023-07-20",
        "certification_date": "2023-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "8035",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Medford, WI

Sources for this page

Verify at the official NPI Registry.