Heide Wakefield-Thorne

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

5775-33 Issued in WI

Practice address

37007 65TH CT
Burlington, WI 53105-8554

Phone

(262) 945-3050

NPI assigned

Jul 2, 2014

Last updated

Jul 2, 2014By the provider in NPPES

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

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

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Kenosha Urgicare

  • Urgent Care Clinic/Center
  • Kenosha, WI
  • NPI 1629373204
  Medicare reassignment NPD

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

{
    "created_epoch": "1404259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404259200000",
    "number": "1669888335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "37007 65TH CT",
            "city": "BURLINGTON",
            "state": "WI",
            "postal_code": "531058554",
            "telephone_number": "262-945-3050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "37007 65TH CT",
            "city": "BURLINGTON",
            "state": "WI",
            "postal_code": "531058554",
            "telephone_number": "262-945-3050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAKEFIELD-THORNE",
        "first_name": "HEIDE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-07-02",
        "last_updated": "2014-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "5775-33",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gretchen Wagner
• Michelle Jayne Wagner, M.D.
• Paul Francis Wagner, MD
• Richard F Wagner, M.D.
• Donald Francis Wahl, LMT
• Wal-Mart Stores East LP (Walmart Pharmacy 10-3488)
• Wal-Mart Stores East, LP (Vision Center 30-3488)
• Amanda Waldera, DPT
• Walgreen Co (Walgreens #10584)
• Abigail Wallace

• Family Nurse Practitioner in Burlington, WI
• Providers in Burlington, WI by specialty
• Family Nurse Practitioner in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2014; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.