Individual provider Active NPI

Ramona S Klevgard, APNP

  • Nurse Practitioner
  • Peshtigo, WI
National Provider Identifier
1710403324
Registry record updated Oct 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
7897 Issued in WI
Practice address
501 N Lake St
Peshtigo, WI 54157-1013
Phone
(715) 582-3906
Fax
(715) 582-3141
NPI assigned
Aug 15, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 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 7897 WI Primary

Addresses

Primary practice location

501 N Lake St
Peshtigo, WI 54157-1013

Mailing address

PO Box 735044
Chicago, IL 60673-5044

Other identifiers 1

IdentifierTypeStateIssuer
100071896MedicaidWI

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address rklevgard90961@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
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
I20171026002607 WI Practitioner - Nurse Practitioner 7012283104 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Aurora Medical Group, Inc.Group PAC ID 6709794258, 3,764 clinicians

Practice addresses (Care Compare)

3003 University Dr
Marinette, WI 54143-4110
Phone (715) 735-6621

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7897WIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Aurora Medical Group, Inc. CurrentSince Feb 1, 2020 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Feb 1, 2020 Accepting new patients

Locations

N306 Maple St
Stephenson, MI 49887
Phone (906) 753-2231

3003 University Dr
Marinette, WI 54143
Phone (715) 735-4200

4061 Old Peshtigo Rd
Marinette, WI 54143
Phone (715) 732-8000

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

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

603 French St
Peshtigo, WI 54157
Phone (715) 582-3622

501 N Lake St
Peshtigo, WI 54157
Phone (715) 582-2278

Interoperability endpoints

  • Direct secure messaging: rklevgard90961@direct.myadvocateaurora.org

Organizations & group practices 2

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": "1502755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696204800000",
    "number": "1710403324",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 N LAKE ST",
            "city": "PESHTIGO",
            "state": "WI",
            "postal_code": "541571013",
            "telephone_number": "715-582-3906",
            "fax_number": "715-582-3141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLEVGARD",
        "first_name": "RAMONA",
        "middle_name": "S",
        "credential": "APNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-15",
        "last_updated": "2023-10-02",
        "certification_date": "2023-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "7897",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100071896",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rklevgard90961@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "4061 Old Peshtigo Rd",
            "city": "Marinette",
            "state": "WI",
            "country_code": "US",
            "postal_code": "541433887",
            "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": "4061 Old Peshtigo Rd",
            "city": "Marinette",
            "state": "WI",
            "country_code": "US",
            "postal_code": "541433887",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Peshtigo, WI

Sources for this page

Verify at the official NPI Registry.