NPIMap

Individual provider Active NPI

Cathy Ann Hunter, PA

  • Physician Assistant
  • Johnson Creek, WI
National Provider Identifier
1669670345
Registry record updated Sep 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2149 Issued in WI
Practice address
480 Village Walk LN Ste F
Johnson Creek, WI 53038-9462
Phone
(920) 542-3010
Fax
(920) 699-9699
NPI assigned
Jul 5, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 2149 WI Primary

Addresses

Primary practice location

480 Village Walk LN Ste F
Johnson Creek, WI 53038-9462

Mailing address

480 Village Walk LN Ste F
Johnson Creek, WI 53038-9462
Phone (920) 542-3010

Other practice location 1

1025 Mulberry St
Lake Mills, WI 53551-1304
Phone (920) 648-4518

Other identifiers 1

IdentifierTypeStateIssuer
1669670345MedicaidWI

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
I20080618000793 WI Practitioner - Physician Assistant 1355412347 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Three Oaks Health SCGroup PAC ID 4486935624, 4 clinicians

Practice addresses (Care Compare)

5 Hartwig Dr
Johnson Creek, WI 53038-9630
Phone (920) 542-3010

Hospital & facility affiliations

  • Commonheart Home Health Home health agency, Waukesha, WI, CCN 527151
  • Watertown Memorial Hospital Hospital, Watertown, WI, CCN 520116
  • Fort Memorial Hospital Hospital, Fort Atkinson, WI, CCN 520071
  • Oconomowoc Memorial Hospital Hospital, Oconomowoc, WI, CCN 520062

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
2149WIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Watertown Physician Practices LLC Physician Assistant Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: cathy.hunter.1@14711.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/14711/brand/1/csg/1/fhir/r4

Organizations & group practices 2

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 6

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": "1183593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537747200000",
    "number": "1669670345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "480 VILLAGE WALK LN STE F",
            "city": "JOHNSON CREEK",
            "state": "WI",
            "postal_code": "530389462",
            "telephone_number": "920-542-3010",
            "fax_number": "920-699-9699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "480 VILLAGE WALK LN STE F",
            "city": "JOHNSON CREEK",
            "state": "WI",
            "postal_code": "530389462",
            "telephone_number": "920-542-3010",
            "fax_number": "920-699-9699"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1025 Mulberry St",
            "address_purpose": "LOCATION",
            "city": "Lake Mills",
            "state": "WI",
            "postal_code": "535511304",
            "country_code": "US",
            "telephone_number": "920-648-4518",
            "fax_number": "920-648-3457",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HUNTER",
        "first_name": "CATHY",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-05",
        "last_updated": "2018-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "2149",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1669670345",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnson Creek, WI

Sources for this page

Verify at the official NPI Registry.