Individual provider Active NPI

Heather Kristine Elertson, NP

  • Nurse Practitioner
  • Green Bay, WI
National Provider Identifier
1619523115
Registry record updated Jun 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
9485 Issued in WI
Practice address
2845 Greenbrier Rd
Green Bay, WI 54311-6519
Phone
(414) 646-2550
NPI assigned
Aug 12, 2019
Last updated
Jun 16, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 9485 WI Primary
Family Nurse Practitioner 363LF0000X 9485-33 WI

Addresses

Primary practice location

2845 Greenbrier Rd
Green Bay, WI 54311-6519

Mailing address

PO Box 735044
Chicago, IL 60673-5044
Phone (800) 326-2250

Other practice location 1

W2035 Auburn Ashford Dr
Campbellsport, WI 53010-3138
Phone (262) 305-1877

Other practice location 2

100 County Road B
Shawano, WI 54166-7072
Phone (715) 524-2161

Other identifiers 1

IdentifierTypeStateIssuer
100097672MedicaidWI

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
I20200311000061 WI Practitioner - Nurse Practitioner 3678901444 Reassigns benefits to 3 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

Practice addresses (Care Compare)

100 County Rd B
Shawano, WI 54166-7072
Phone (715) 526-2111

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9485WIMDNurse Practitioner
9485-33WIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Thedacare Medical Center - Shawano, Inc. CurrentSince Mar 1, 2020 Accepting new patients
Thedacare, Incorporated CurrentSince Mar 1, 2020 Accepting new patients
Thedacare, Incorporated CurrentSince Mar 1, 2020 Accepting new patients
Thedacare Medical Center - Shawano, Inc. CurrentSince Mar 1, 2020 Accepting new patients
Thedacare Medical Center - Berlin, Inc. Past Accepting new patients

Locations

122 E College Ave
Appleton, WI 54911
Phone (920) 996-3264

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

225 Memorial Dr
Berlin, WI 54923
Phone (920) 361-1313

370 S Main St
Clintonville, WI 54929
Phone (715) 526-7370

600 N Westhaven Dr
Oshkosh, WI 54904
Phone (920) 237-5000

100 Cty Road B
Shawano, WI 54166
Phone (715) 524-2161

Interoperability endpoints

  • Direct secure messaging: helertson286803@direct.thedacare.org

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.

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": "1565568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781568000000",
    "number": "1619523115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 735044",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606735044",
            "telephone_number": "800-326-2250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2845 GREENBRIER RD",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543116519",
            "telephone_number": "414-646-2550"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "W2035 Auburn Ashford Dr",
            "address_purpose": "LOCATION",
            "city": "Campbellsport",
            "state": "WI",
            "postal_code": "530103138",
            "country_code": "US",
            "telephone_number": "262-305-1877",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "100 County Road B",
            "address_purpose": "LOCATION",
            "city": "Shawano",
            "state": "WI",
            "postal_code": "541667072",
            "country_code": "US",
            "telephone_number": "715-524-2161",
            "fax_number": "715-526-3461",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELERTSON",
        "first_name": "HEATHER",
        "middle_name": "KRISTINE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-12",
        "last_updated": "2026-06-16",
        "certification_date": "2026-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "9485",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "9485-33",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100097672",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Green Bay, WI

Sources for this page

Verify at the official NPI Registry.