Individual provider Active NPI

Barbara Theisen

  • Nurse Practitioner
  • Friendship, WI
National Provider Identifier
1740733617
Registry record updated Aug 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
7143-33 Issued in WI
Practice address
402 W Lake St
Friendship, WI 53934-9699
Phone
(608) 339-3331
NPI assigned
Jul 27, 2016
Last updated
Aug 9, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2016

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 7143-33 WI Primary
Registered Nurse 163W00000X 119037-30 WI

Addresses

Primary practice location

402 W Lake St
Friendship, WI 53934-9699

Mailing address

402 W Lake St
Friendship, WI 53934-9699
Phone (608) 339-3331

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
I20160915001501 WI Practitioner - Nurse Practitioner 6103112248 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
MCHS Hospitals IncGroup PAC ID 5698071173, 1,195 clinicians

Practice addresses (Care Compare)

1000 N Oak Ave
Marshfield, WI 54449-5703
Phone (715) 387-5511

220 24TH St S
Wisconsin Rapids, WI 54494-1908
Phone (715) 751-6200

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
119037-30WIMDRegistered Nurse
7143-33WIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
MCHS Hospitals Inc Current Accepting new patients
MCHS Hospitals Inc CurrentSince Jul 22, 2019 Accepting new patients
MCHS Hospitals Inc CurrentSince Jul 22, 2019 Accepting new patients
Moundview Memorial Hospital & Clinics, Inc. CurrentSince Aug 13, 2016 Accepting new patients
Moundview Memorial Hospital & Clinics, Inc CurrentSince Aug 13, 2016 Accepting new patients
Marshfield Clinic Inc CurrentSince Jul 22, 2019 Accepting new patients
Memorial Hospital Inc Past Accepting new patients
Memorial Hospital Inc Past Accepting new patients

Locations

1000 Starr Ave
Eau Claire, WI 54703
Phone (715) 858-4850

3501 Golf Rd
Eau Claire, WI 54701
Phone (715) 858-4200

402 W Lake St
Friendship, WI 53934
Phone (608) 339-3331

1000 N Oak Ave
Marshfield, WI 54449
Phone (715) 387-5111

220 24th St S
Wisconsin Rapids, WI 54494
Phone (715) 424-8600

Interoperability endpoints

  • Direct secure messaging: barbara.theisen@marshfieldclinichealthsystem.cernerdirect.com

Organizations & group practices 8

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.

Hospital & facility affiliations 3

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": "1469577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470700800000",
    "number": "1740733617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "402 W LAKE ST",
            "city": "FRIENDSHIP",
            "state": "WI",
            "postal_code": "539349699",
            "telephone_number": "608-339-3331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 W LAKE ST",
            "city": "FRIENDSHIP",
            "state": "WI",
            "postal_code": "539349699",
            "telephone_number": "608-339-3331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THEISEN",
        "first_name": "BARBARA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-27",
        "last_updated": "2016-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "7143-33",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WI",
            "license": "119037-30",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Friendship, WI

Sources for this page

Verify at the official NPI Registry.