Individual provider Active NPI

Allison Lynch, APNP

  • Nurse Practitioner
  • Beaver Dam, WI
National Provider Identifier
1689310419
Registry record updated Jul 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
11922 Issued in WI
Practice address
130 Corporate Dr
Beaver Dam, WI 53916-3116
Phone
(920) 887-3102
Fax
(920) 855-8790
NPI assigned
May 5, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 11922 WI Primary

Addresses

Primary practice location

130 Corporate Dr
Beaver Dam, WI 53916-3116

Mailing address

130 Corporate Dr
Beaver Dam, WI 53916-3116
Phone (920) 960-2136

Other identifiers 1

IdentifierTypeStateIssuer
1689310419MedicaidWI

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address alynch381320@direct-ehr-ssmhc.com Direct
FHIR URL https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/ Other

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20230624000232 WI Practitioner - Nurse Practitioner 5193183044 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Agnesian Healthcare IncGroup PAC ID 1658289624, 392 clinicians
Dean Health Systems IncGroup PAC ID 7012827983, 1,174 clinicians

Practice addresses (Care Compare)

130 Corporate Dr
Beaver Dam, WI 53916-3116
Phone (920) 887-3102

Hospital & facility affiliations

  • Waupun Memorial Hospital Hospital, Waupun, WI, CCN 521327
  • Columbus Community Hospital Hospital, Columbus, WI, CCN 521338
  • Marshfield Medical Center - Beaver Dam (MMC-BD) Hospital, Beaver Dam, WI, CCN 520076
  • SSM Health St Agnes Hospital-Fond Du Lac Hospital, Fond Du Lac, WI, CCN 520088

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11922WIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Agnesian Healthcare Inc CurrentSince Jul 1, 2023 Accepting new patients
Dean Health Systems, Inc. CurrentSince Jul 6, 2023 Accepting new patients
Agnesian Healthcare Inc CurrentSince Jul 1, 2023 Accepting new patients
Agnesian Healthcare, Inc Current Accepting new patients
Dean Health Systems, Inc CurrentSince Jul 6, 2023 Accepting new patients

Locations

130 Corporate Dr
Beaver Dam, WI 53916
Phone (920) 877-3102

1808 W Beltline Hwy
Madison, WI 53713
Phone (608) 250-1497

360 S Mountin Dr
Mayville, WI 53050
Phone (920) 387-2111

515 22nd Ave
Monroe, WI 53566
Phone (608) 324-1000

Interoperability endpoints

  • Direct secure messaging: apolenska330105@direct-ehr-ssmhc.com

Organizations & group practices 5

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 8

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": "1651708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689552000000",
    "number": "1689310419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 CORPORATE DR",
            "city": "BEAVER DAM",
            "state": "WI",
            "postal_code": "539163116",
            "telephone_number": "920-960-2136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 CORPORATE DR",
            "city": "BEAVER DAM",
            "state": "WI",
            "postal_code": "539163116",
            "telephone_number": "920-887-3102",
            "fax_number": "920-855-8790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYNCH",
        "first_name": "ALLISON",
        "credential": "APNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-05",
        "last_updated": "2023-07-17",
        "certification_date": "2023-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "11922",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1689310419",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "alynch381320@direct-ehr-ssmhc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "alynch381320@direct-ehr-ssmhc.com",
            "address_1": "130 Corporate Dr",
            "city": "Beaver Dam",
            "state": "WI",
            "country_code": "US",
            "postal_code": "539163116",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "130 Corporate Dr",
            "city": "Beaver Dam",
            "state": "WI",
            "country_code": "US",
            "postal_code": "539163116",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Beaver Dam, WI

Sources for this page

Verify at the official NPI Registry.