Mary Kay Nissen

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

A-076138 Issued in IA

Practice address

3303 Rebecca St
Sioux City, IA 51104-2324

Phone

(712) 279-5458

NPI assigned

Sep 11, 2009

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Mary Kay Studer Former name

Medicare fee-for-service enrollment

Enrolled in IA, SD2 enrollments

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 2

Specialty

Nurse Practitioner

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Shenandoah Medical CenterGroup PAC ID 9436063237, shared by 7 NPIs, 52 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Shenandoah Medical Center Hospital, Shenandoah, IA, CCN 161366

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Shenandoah Medical Center

  • Certified Registered Nurse Anesthetist
  • Shenandoah, IA
  • NPI 1497810972
  Medicare reassignment NPD
• Avera McKennan

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Sioux Falls, SD
  • NPI 1699009944
  Medicare reassignment NPD
• Shenandoah Medical Center

  • Rural Health Clinic/Center
  • Shenandoah, IA
  • NPI 1427300201
  NPD
• Shenandoah Medical Center

  • Community/Retail Pharmacy
  • Shenandoah, IA
  • NPI 1447937230
  NPD
• Shenandoah Medical Center

  • Emergency Medicine Physician
  • Shenandoah, IA
  • NPI 1497810956
  NPD
• American Advanced Practice Network, P.C.

  • Nurse Practitioner
  • Watertown, SD
  • NPI 1790244341
  NPD
• Avera McKennan

  • Diagnostic Radiology Physician
  • Sioux Falls, SD
  • NPI 1053680678
  NPD
• Avera McKennan

  • Family Medicine Physician
  • Sioux Falls, SD
  • NPI 1376575514

  Nurse Practitioner

  NPD
• Affordable Medical Care LLC

  • Clinic/Center
  • Sioux City, IA
  • NPI 1164702239
  NPD (past)
• Shenandoah Medical Center

  • Critical Access Hospital
  • Shenandoah, IA
  • NPI 1184621096
  NPD (past)
• Modern Day Health Care Prof LLC

  • Multi-Specialty Clinic/Center
  • Aberdeen, SD
  • NPI 1851883540
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Shenandoah Medical Center

  • Critical Access Hospital
  • Shenandoah, IA
  • NPI 1184621096
  Care Compare affiliation

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

{
    "created_epoch": "1252627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696291200000",
    "number": "1659604403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3303 REBECCA ST",
            "city": "SIOUX CITY",
            "state": "IA",
            "postal_code": "511042324",
            "telephone_number": "712-279-5458"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3303 REBECCA ST",
            "city": "SIOUX CITY",
            "state": "IA",
            "postal_code": "511042324",
            "telephone_number": "712-279-5458"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NISSEN",
        "first_name": "MARY",
        "middle_name": "KAY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-09-11",
        "last_updated": "2023-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IA",
            "license": "A-076138",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "STUDER",
            "middle_name": "KAY",
            "credential": "ARNP-BC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Mark W Nielsen, M.D.
• Kimberlee Niemeier, LBSW, CADC
• Erik Nieuwenhuis, PT
• Timothy Dean Nikkel
• Wade A Nilson, P.A.
• Dennis Michael Nitz, MD
• Chidinma Nmerenu, MD
• Gregory Lee Nooney, MSW
• Tory Norby, M.A. SLP
• Danelle Noreen

• Nurse Practitioner in Sioux City, IA
• Providers in Sioux City, IA by specialty
• Nurse Practitioner in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.