Individual provider Active NPI

Kelly Jossart, APNP, PMHNP-BC

  • Nurse Practitioner
  • Mauston, WI
National Provider Identifier
1689391674
Registry record updated Feb 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
13251-33 Issued in WI
Practice address
200 Hickory St
Mauston, WI 53948-2101
Phone
(608) 847-2400
Fax
(608) 847-9599
NPI assigned
Oct 20, 2022
Last updated
Feb 21, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2024

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 13251-33 WI Primary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 13251 WI

Addresses

Primary practice location

200 Hickory St
Mauston, WI 53948-2101

Mailing address

200 Hickory St
Mauston, WI 53948-2101
Phone (608) 847-2400

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
I20230203000853 WI Practitioner - Nurse Practitioner 2769854553 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
13251-33WIMDNurse Practitioner
13251WIMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Juneau County CurrentSince Nov 1, 2022 Accepting new patients
Aspiring Horizons Psychiatric/Mental Health CurrentSince Dec 6, 2022 Accepting new patients
Juneau County CurrentSince Nov 1, 2022 Accepting new patients

Locations

200 S Hickory St
Mauston, WI 53948
Phone (608) 847-2400

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1666224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708473600000",
    "number": "1689391674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 HICKORY ST",
            "city": "MAUSTON",
            "state": "WI",
            "postal_code": "539482101",
            "telephone_number": "608-847-2400",
            "fax_number": "608-847-9599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 HICKORY ST",
            "city": "MAUSTON",
            "state": "WI",
            "postal_code": "539482101",
            "telephone_number": "608-847-2400",
            "fax_number": "608-847-9599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOSSART",
        "first_name": "KELLY",
        "credential": "APNP, PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-20",
        "last_updated": "2024-02-21",
        "certification_date": "2024-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "13251-33",
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WI",
            "license": "13251",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mauston, WI

Sources for this page

Verify at the official NPI Registry.