Individual provider Active NPI

Adrienne A Hernandez, PT

  • Physical Therapist
  • Shawano, WI
National Provider Identifier
1699258871
Registry record updated Oct 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
14420-24 Issued in WI
Practice address
1346 E Green Bay St
Shawano, WI 54166-2210
Phone
(715) 526-6244
Fax
(715) 526-2328
NPI assigned
Sep 13, 2018
Last updated
Oct 8, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 14420-24 WI Primary

Addresses

Primary practice location

1346 E Green Bay St
Shawano, WI 54166-2210

Mailing address

PO Box 735044
Chicago, IL 60673-5044
Phone (800) 326-2250

Other identifiers 1

IdentifierTypeStateIssuer
100082289MedicaidWI

Other names 1

  • Adrienne Bohnert Former name

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address abohnert191216@direct.myadvocateaurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181113000311 WI Practitioner - Physical Therapist in Private Practice 4486908381 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
14420-24WIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Baycare Aurora, LLC CurrentSince Apr 30, 2019 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Sep 25, 2018 Accepting new patients
Aurora Medical Group, Inc. Current Accepting new patients
Aurora Medical Group, Inc. CurrentSince Sep 25, 2018 Accepting new patients

Locations

2253 W Mason St
Green Bay, WI 54303
Phone (920) 327-7000

3237 Voyager Dr
Green Bay, WI 54311
Phone (920) 468-8288

1020 N 12th St
Milwaukee, WI 53233
Phone (414) 219-3056

3301 W Forest Home Ave
Milwaukee, WI 53215
Phone (414) 389-2233

1346 E Green Bay St
Shawano, WI 54166
Phone (715) 526-6244

Interoperability endpoints

  • Direct secure messaging: abohnert191216@direct.myadvocateaurora.org

Organizations & group practices 4

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": "1536796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728345600000",
    "number": "1699258871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 735044",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606735044",
            "telephone_number": "800-326-2250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1346 E GREEN BAY ST",
            "city": "SHAWANO",
            "state": "WI",
            "postal_code": "541662210",
            "telephone_number": "715-526-6244",
            "fax_number": "715-526-2328"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERNANDEZ",
        "first_name": "ADRIENNE",
        "middle_name": "A",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-13",
        "last_updated": "2024-10-08",
        "certification_date": "2024-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "14420-24",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100082289",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "abohnert191216@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "3237 Voyager Dr",
            "city": "Green Bay",
            "state": "WI",
            "country_code": "US",
            "postal_code": "543118349",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "3237 Voyager Dr",
            "city": "Green Bay",
            "state": "WI",
            "country_code": "US",
            "postal_code": "543118349",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "ADRIENNE",
            "last_name": "BOHNERT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Shawano, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.