Individual provider Active NPI

Cassandra Marie Gollakner, DNP, FNP-BC

  • Family Nurse Practitioner
  • Iron Mountain, MI
National Provider Identifier
1740961069
Registry record updated Dec 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
14340-33 Issued in WI
Practice address
440 Woodward Ave
Iron Mountain, MI 49801-4631
Phone
(906) 776-9040
Fax
(906) 774-5950
NPI assigned
Jul 28, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 14340-33 WI Primary
Registered Nurse 163W00000X 255675-30 WI

Addresses

Primary practice location

440 Woodward Ave
Iron Mountain, MI 49801-4631

Mailing address

PO Box 22487
Green Bay, WI 54305-2487
Phone (920) 445-7210

Other practice location 1

610 S Lincoln Rd
Escanaba, MI 49829-1215
Phone (906) 786-6488

Other practice location 2

2820 Roosevelt Rd
Marinette, WI 54143-3834
Phone (715) 735-5225

Other identifiers 1

IdentifierTypeStateIssuer
2023060758OtherAMERICAN NURSES CREDENTIALING CENTER

Other names 1

  • Cassandra Marie Dumke Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, MI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20231122002539 WI Practitioner - Nurse Practitioner 7012365471 Reassigns benefits to 2 organizations
I20231213001303 MI Practitioner - Nurse Practitioner 7012365471 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Oconto Hospital and Medical Center Inc 217 clinicians
Bellin Memorial Hospital Inc 685 clinicians

Practice addresses (Care Compare)

2820 Roosevelt Rd
Marinette, WI 54143-3834
Phone (715) 735-5225

440 Woodward Ave
Iron Mountain, MI 49801-4631
Phone (906) 776-9040

744 S Webster Ave
Green Bay, WI 54301-3505
Phone (920) 433-6025

820 Arbutus Ave
Oconto, WI 54153-2004
Phone (920) 835-1100

Hospital & facility affiliations

  • Marshfield Medical Center Hospital, Iron Mountain, MI, CCN 231342
  • Aurora Medical Center Bay Area Hospital, Marinette, WI, CCN 520113

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
255675-30WIMDRegistered Nurse
14340-33WIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Oconto Hospital & Medical Center Inc CurrentSince Nov 1, 2023 Accepting new patients
Oconto Hospital & Medical Center Inc CurrentSince Nov 1, 2023 Accepting new patients
Bellin Memorial Hospital Inc Current Accepting new patients
Bellin Memorial Hospital Inc CurrentSince Sep 18, 2023 Accepting new patients
Bellin Memorial Hospital Inc CurrentSince Sep 18, 2023 Accepting new patients
Bellin Memorial Hospital Inc Current Accepting new patients
Oconto Hospital & Medical Center Inc Current Accepting new patients
Bellin Memorial Hospital Inc Past Accepting new patients

Locations

610 S Lincoln Rd
Escanaba, MI 49829
Phone (906) 786-6488

440 Woodward Ave
Iron Mountain, MI 49801
Phone (906) 776-9040

744 S Webster Ave
Green Bay, WI 54301
Phone (920) 433-6025

2820 Roosevelt Rd
Marinette, WI 54143
Phone (715) 330-6171

820 Arbutus Ave
Oconto, WI 54153
Phone (920) 835-1100

Interoperability endpoints

  • Direct secure messaging: cgollakner332545@direct.thedacare.org
  • Direct secure messaging: cgollakner925535@direct.emplifyhealth.org

Organizations & group practices 24

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.

View all 24

Hospital & facility affiliations 4

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": "1690502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701907200000",
    "number": "1740961069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 22487",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543052487",
            "telephone_number": "920-445-7210",
            "fax_number": "920-445-7289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "440 WOODWARD AVE",
            "city": "IRON MOUNTAIN",
            "state": "MI",
            "postal_code": "498014631",
            "telephone_number": "906-776-9040",
            "fax_number": "906-774-5950"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "610 S Lincoln Rd",
            "address_purpose": "LOCATION",
            "city": "Escanaba",
            "state": "MI",
            "postal_code": "498291215",
            "country_code": "US",
            "telephone_number": "906-786-6488",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2820 Roosevelt Rd",
            "address_purpose": "LOCATION",
            "city": "Marinette",
            "state": "WI",
            "postal_code": "541433834",
            "country_code": "US",
            "telephone_number": "715-735-5225",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOLLAKNER",
        "first_name": "CASSANDRA",
        "middle_name": "MARIE",
        "credential": "DNP, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-28",
        "last_updated": "2023-12-07",
        "certification_date": "2023-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "14340-33",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WI",
            "license": "255675-30",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICAN NURSES CREDENTIALING CENTER",
            "identifier": "2023060758",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CASSANDRA",
            "last_name": "DUMKE",
            "middle_name": "MARIE",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Iron Mountain, MI

Sources for this page

Verify at the official NPI Registry.