Individual provider Active NPI

Alicia Cleven, NP

  • Nurse Practitioner
  • Fennimore, WI
National Provider Identifier
1750763603
Registry record updated Feb 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
11734-33 Issued in WI
Practice address
1380 13TH St
Fennimore, WI 53809-1910
Phone
(608) 732-4397
NPI assigned
Jun 26, 2015
Last updated
Feb 9, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2022

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 11734-33 WI Primary
Registered Nurse 163W00000X 168027-30 WI

Addresses

Primary practice location

1380 13TH St
Fennimore, WI 53809-1910

Mailing address

1380 13TH St
Fennimore, WI 53809-1910
Phone (608) 732-4397

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
I20220531002461 WI Practitioner - Nurse Practitioner 7214315449 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
168027-30WIMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Springtime Health and Wellness, SC CurrentSince Mar 1, 2022 Accepting new patients

Locations

1001 S Whitney Way
Madison, WI 53711
Phone (608) 274-6200

Organizations & group practices 1

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": "1435276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644364800000",
    "number": "1750763603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1380 13TH ST",
            "city": "FENNIMORE",
            "state": "WI",
            "postal_code": "538091910",
            "telephone_number": "608-732-4397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1380 13TH ST",
            "city": "FENNIMORE",
            "state": "WI",
            "postal_code": "538091910",
            "telephone_number": "608-732-4397"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLEVEN",
        "first_name": "ALICIA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-26",
        "last_updated": "2022-02-09",
        "certification_date": "2022-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "11734-33",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WI",
            "license": "168027-30",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fennimore, WI

Sources for this page

Verify at the official NPI Registry.