Kelly M Mackowski, APNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

9839 Issued in WI

Practice address

100 County Road B
Shawano, WI 54166-7072

Phone

(715) 526-2111

NPI assigned

Jan 24, 2020

Last updated

May 25, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Green Bay Emergency Medicine Services SCGroup PAC ID 9335170083, 16 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Bellin Memorial Hospital Hospital, Green Bay, WI, CCN 520049

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kmackowski1088524@direct.emplifyhealth.org
• Direct secure messaging: kmackowski285370@direct.thedacare.org

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.

• Green Bay Emergency Medicine Services S.C.

  • Emergency Medicine Physician
  • Green Bay, WI
  • NPI 1366424111
  Medicare reassignment Care Compare group NPD
• Thedacare Medical Center - Shawano, Inc.

  • Critical Access Hospital
  • Shawano, WI
  • NPI 1548260839
  Medicare reassignment NPD
• Thedacare Medical Center - Waupaca, Inc.

  • Emergency Medicine Physician
  • Waupaca, WI
  • NPI 1780782680

  Nurse Practitioner

  Medicare reassignment NPD
• Richard S Veiga MD SC

  • Anatomic Pathology & Clinical Pathology Physician
  • Waupaca, WI
  • NPI 1861434631
  NPD
• Thedacare Medical Center - Shawano, Inc.

  dba ThedaCare Apothecary-Shawano

  • Community/Retail Pharmacy
  • Shawano, WI
  • NPI 1306516604
  NPD
• Thedacare Medical Center - Waupaca, Inc.

  dba ThedaCare Apothecary-Waupaca

  • Community/Retail Pharmacy
  • Waupaca, WI
  • NPI 1558031856
  NPD

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

• Bellin Memorial Hospital Inc.

  • General Acute Care Hospital
  • Green Bay, WI
  • NPI 1891740585
  Care Compare affiliation

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

{
    "created_epoch": "1579824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653436800000",
    "number": "1689204075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 NEENAH CTR",
            "city": "NEENAH",
            "state": "WI",
            "postal_code": "549563070",
            "telephone_number": "715-526-2111",
            "fax_number": "715-526-7308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 COUNTY ROAD B",
            "city": "SHAWANO",
            "state": "WI",
            "postal_code": "541667072",
            "telephone_number": "715-526-2111"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1818 N Meade St Ste 130",
            "address_purpose": "LOCATION",
            "city": "Appleton",
            "state": "WI",
            "postal_code": "549113454",
            "country_code": "US",
            "telephone_number": "920-831-1841",
            "fax_number": "920-831-1834",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "800 Riverside Dr",
            "address_purpose": "LOCATION",
            "city": "Waupaca",
            "state": "WI",
            "postal_code": "549811943",
            "country_code": "US",
            "telephone_number": "715-258-1000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MACKOWSKI",
        "first_name": "KELLY",
        "middle_name": "M",
        "credential": "APNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-24",
        "last_updated": "2022-05-25",
        "certification_date": "2022-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "9839",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rachel Ann Lohrengel, D-PT
• Vince D Long, SAC
• May Kaying Lor
• Adrienne Luebke, PHARMD
• Kelly Ann Maas, MSE, LPC, SAS
• Janson A Mancheski, OD
• Manor Care of Shawano Wi LLC (ManorCare Health Services - Shawano)
• Paul S Mantz, DDS
• Maple Lane Health & Rehabilitation Center LLC (D/B/a Atrium Post Acute Care of Shawano at Maple Lane)
• Katie Marie Marquardt

• Family Nurse Practitioner in Shawano, WI
• Providers in Shawano, 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 May 25, 2022; 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.