Individual provider Active NPI

Kristin M Roesler, APNP

  • Family Nurse Practitioner
  • New London, WI
National Provider Identifier
1679932750
Registry record updated May 9, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
6822 Issued in WI
Practice address
1405 Mill St
New London, WI 54961-2155
Phone
(922) 531-2400
Fax
(920) 531-2450
NPI assigned
Feb 17, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 9, 2017

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 6822 WI
Family Nurse Practitioner 363LF0000X 6822 WI Primary

Addresses

Primary practice location

1405 Mill St
New London, WI 54961-2155

Mailing address

PO Box 8003
Appleton, WI 54912-8003
Phone (920) 830-5900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6822WIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Thedacare, Incorporated CurrentSince Feb 22, 2016 Accepting new patients

Locations

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

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

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

Interoperability endpoints

  • Direct secure messaging: kristin.roesler@337248305217540.direct.elationemr.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1455667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1494288000000",
    "number": "1679932750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8003",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549128003",
            "telephone_number": "920-830-5900",
            "fax_number": "920-738-5787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1405 MILL ST",
            "city": "NEW LONDON",
            "state": "WI",
            "postal_code": "549612155",
            "telephone_number": "922-531-2400",
            "fax_number": "920-531-2450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROESLER",
        "first_name": "KRISTIN",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "APNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-17",
        "last_updated": "2017-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "6822",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "6822",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New London, WI

Sources for this page

Verify at the official NPI Registry.