NPIMap

Individual provider Active NPI

Beau E Brackey, APNP

  • Family Nurse Practitioner
  • Appleton, WI
National Provider Identifier
1659845238
Registry record updated Jul 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
8970 Issued in WI
Practice address
2500 E Capitol Dr Ste 1700
Appleton, WI 54911-8735
Phone
(920) 731-8131
Fax
(920) 832-0444
NPI assigned
Jan 16, 2019
Sex
Male
Sole proprietor
No

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.

Hospital & facility affiliations 14

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

View all 14

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fox Valley Surgical Associates LTD 35 clinicians

Practice addresses (Care Compare)

2500 E Capitol Dr
Suite 1700
Appleton, WI 54911-8735
Phone (920) 731-8131

Hospital & facility affiliations

  • Thedacare Regional Medical Center - Appleton Inc Hospital, Appleton, WI, CCN 520160
  • Thedacare Regional Med Ctr - Neenah Hospital, Neenah, WI, CCN 520045
  • Thedacare Medical Center-Waupaca Hospital, Waupaca, WI, CCN 521334

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
I20190226003284 WI Practitioner - Nurse Practitioner 9234478876 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Fox Valley Surgical Associates LTD CurrentSince Jul 18, 2022 Accepting new patients

Locations

1818 N Meade St
Ste 240W
Appleton, WI 54911

2000 E Milestone Dr
Appleton, WI 54913
Phone (920) 358-1729

2500 E Capitol Dr
Ste 1700
Appleton, WI 54911
Phone (920) 734-9600

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

1405 Mill St
New London, WI 54961
Phone (920) 531-2000

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

800 Riverside Dr
Waupaca, WI 54981
Phone (715) 258-1000

710 Riverside Dr
Waupaca, WI 54981
Phone (715) 256-3000

Interoperability endpoints

  • Direct secure messaging: bbrackey31187@direct.thedacare.org

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 8970 WI Primary

Addresses

NPPES NPI Registry

Primary practice location

2500 E Capitol Dr Ste 1700
Appleton, WI 54911-8735

Mailing address

2000 E Milestone Dr
Appleton, WI 54913-6701
Phone (920) 731-8131

Other practice location 1

710 Riverside Dr
Waupaca, WI 54981-1941
Phone (715) 256-3000

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 19, 2023.

{
    "created_epoch": "1547596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689724800000",
    "number": "1659845238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 E MILESTONE DR",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549136701",
            "telephone_number": "920-731-8131",
            "fax_number": "920-832-0444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 E CAPITOL DR STE 1700",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549118735",
            "telephone_number": "920-731-8131",
            "fax_number": "920-832-0444"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "710 Riverside Dr",
            "address_purpose": "LOCATION",
            "city": "Waupaca",
            "state": "WI",
            "postal_code": "549811941",
            "country_code": "US",
            "telephone_number": "715-256-3000",
            "fax_number": "715-256-3039",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRACKEY",
        "first_name": "BEAU",
        "middle_name": "E",
        "credential": "APNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-01-16",
        "last_updated": "2023-07-19",
        "certification_date": "2023-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "8970",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Appleton, WI

Sources for this page

Verify at the official NPI Registry.