NPIMap

Individual provider Active NPI

Rachel Scullion

  • Family Nurse Practitioner
  • Green Bay, WI
National Provider Identifier
1720710668
Registry record updated Sep 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
12058-33 Issued in WI
Practice address
3021 Voyager Dr
Green Bay, WI 54311-8303
Phone
(920) 883-9653
NPI assigned
Jun 29, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 12058-33 WI Primary

Addresses

Primary practice location

3021 Voyager Dr
Green Bay, WI 54311-8303

Mailing address

3021 Voyager Dr
Green Bay, WI 54311-8303
Phone (920) 883-9653

Other names 1

  • Rachel Sidlauskas Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rscullion302224@ewd.direct.hshs.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220725001569 WI Practitioner - Nurse Practitioner 9133500937 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3021 Voyager Dr
Green Bay, WI 54311-8303
Phone (920) 496-4700

Hospital & facility affiliations

  • St Vincent Hospital Hospital, Green Bay, WI, CCN 520075
  • St Marys Hospital Medical Ctr Hospital, Green Bay, WI, CCN 520097

Merit-based Incentive Payment System (MIPS)

Final score
94.81 of 100Reported as apm
Quality
85.98
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
12058-33WIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St. Nicholas Hospital-Sisters of the Third Order of St Francis CurrentSince Jul 1, 2022 Accepting new patients
St. Nicholas Hospital-Sisters of the Third Order of St Francis Current Accepting new patients
St. Clare Memorial Hospital, Inc. CurrentSince Dec 1, 2022 Accepting new patients
St Vincent Hospital-Hospital Sisters-Third Order of St Francis CurrentSince Jul 1, 2022 Accepting new patients
St Vincent Hospital-Hospital Sisters-Third Order of St Francis CurrentSince Jul 1, 2022 Accepting new patients
Prevea Clinic, Inc. CurrentSince Jul 1, 2022 Accepting new patients
Prevea Clinic, Inc. CurrentSince Jul 1, 2022 Accepting new patients
St Clare Memorial Hospital, Inc CurrentSince Dec 1, 2022 Accepting new patients
St Nicholas Hospital-Sisters of the Third Order of St Francis CurrentSince Jul 1, 2022 Accepting new patients
St Vincent Hospital-Hospital Sisters-Third Order of St Francis Past Accepting new patients

Locations

835 S Van Buren St
Green Bay, WI 54301
Phone (888) 901-7246

1726 Shawano Ave
Green Bay, WI 54303
Phone (920) 432-6016

3021 Voyager Dr
Green Bay, WI 54311
Phone (920) 431-1810

1020 Marquette Dr
Kewaunee, WI 54216
Phone (920) 388-0144

4810 Expo Dr
Manitowoc, WI 54220
Phone (920) 717-0800

855 S Main St
Ste 1
Oconto Falls, WI 54154
Phone (920) 846-8187

3100 Superior Ave
Sheboygan, WI 53081
Phone (800) 472-6710

Organizations & group practices 10

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 6

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": "1656460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664409600000",
    "number": "1720710668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3021 VOYAGER DR",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543118303",
            "telephone_number": "920-883-9653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3021 VOYAGER DR",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543118303",
            "telephone_number": "920-883-9653"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCULLION",
        "first_name": "RACHEL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-29",
        "last_updated": "2022-09-29",
        "certification_date": "2022-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "12058-33",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rscullion302224@ewd.direct.hshs.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "3021 Voyager Dr",
            "city": "Green Bay",
            "state": "WI",
            "country_code": "US",
            "postal_code": "543118303",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "RACHEL",
            "last_name": "SIDLAUSKAS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Green Bay, WI

Sources for this page

Verify at the official NPI Registry.