Individual provider Active NPI

Elizabeth Levine

  • Family Nurse Practitioner
  • Green Bay, WI
National Provider Identifier
1750885448
Registry record updated Mar 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
830633 Issued in WI
Practice address
2502 S Ashland Ave
Green Bay, WI 54304-5252
Phone
(920) 496-4700
NPI assigned
Mar 19, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 240659 WI
Family Nurse Practitioner 363LF0000X 830633 WI Primary

Addresses

Primary practice location

2502 S Ashland Ave
Green Bay, WI 54304-5252

Mailing address

2502 S Ashland Ave
Green Bay, WI 54304-5252

Other practice location 1

835 S Main St
Oconto Falls, WI 54154-1282
Phone (920) 496-4700

Other practice location 2

940 S Saint Augustine St
Pulaski, WI 54162-9453
Phone (920) 496-4700

Other practice location 3

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

Other practice location 4

2793 Lineville Rd
Green Bay, WI 54313-7152
Phone (920) 496-4700

Other practice location 5

102 N Washington St
Green Bay, WI 54301-4209
Phone (920) 496-4700

Other practice location 6

3860 Monroe Rd
DE Pere, WI 54115-8399
Phone (920) 496-4700

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
I20180412001717 WI Practitioner - Nurse Practitioner 5193088789 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare

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

State licenses

LicenseStateTypeSpecialty
240659WIMDRegistered Nurse
830633WIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St Clare Memorial Hospital, Inc CurrentSince Jun 1, 2020 Accepting new patients
St Vincent Hospital-Hospital Sisters-Third Order of St Francis CurrentSince Apr 2, 2018 Accepting new patients
St. Nicholas Hospital-Sisters of the Third Order of St Francis Current Accepting new patients
Prevea Clinic, Inc. CurrentSince Apr 2, 2018 Accepting new patients
St Nicholas Hospital-Sisters of the Third Order of St Francis CurrentSince Apr 2, 2018 Accepting new patients
St Vincent Hospital-Hospital Sisters-Third Order of St Francis CurrentSince Apr 2, 2018 Accepting new patients
Prevea Clinic, Inc. CurrentSince Apr 2, 2018 Accepting new patients
St. Clare Memorial Hospital, Inc CurrentSince Jun 1, 2020 Accepting new patients
St. Nicholas Hospital-Sisters of the Third Order of St Francis CurrentSince Apr 2, 2018 Accepting new patients

Locations

3860 Monroe Rd
De Pere, WI 54115
Phone (920) 272-1200

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

2502 S Ashland Ave
Green Bay, WI 54304
Phone (920) 496-4750

102 N Washington St
Green Bay, WI 54301

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

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

2793 Lineville Rd
Howard, WI 54313

835 S Main St
Oconto Falls, WI 54154
Phone (920) 846-0509

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

940 S Saint Augustine St
Pulaski, WI 54162
Phone (920) 272-1611

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

1411 N Taylor Dr
Sheboygan, WI 53081
Phone (920) 457-1600

Organizations & group practices 9

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": "1521417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521763200000",
    "number": "1750885448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2502 S ASHLAND AVE",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543045252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2502 S ASHLAND AVE",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543045252",
            "telephone_number": "920-496-4700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "835 S Main St",
            "address_purpose": "LOCATION",
            "city": "Oconto Falls",
            "state": "WI",
            "postal_code": "541541282",
            "country_code": "US",
            "telephone_number": "920-496-4700",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "940 S Saint Augustine St",
            "address_purpose": "LOCATION",
            "city": "Pulaski",
            "state": "WI",
            "postal_code": "541629453",
            "country_code": "US",
            "telephone_number": "920-496-4700",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3021 Voyager Dr",
            "address_purpose": "LOCATION",
            "city": "Green Bay",
            "state": "WI",
            "postal_code": "543118303",
            "country_code": "US",
            "telephone_number": "920-496-4700",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2793 Lineville Rd",
            "address_purpose": "LOCATION",
            "city": "Green Bay",
            "state": "WI",
            "postal_code": "543137152",
            "country_code": "US",
            "telephone_number": "920-496-4700",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "102 N Washington St",
            "address_purpose": "LOCATION",
            "city": "Green Bay",
            "state": "WI",
            "postal_code": "543014209",
            "country_code": "US",
            "telephone_number": "920-496-4700",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3860 Monroe Rd",
            "address_purpose": "LOCATION",
            "city": "DE Pere",
            "state": "WI",
            "postal_code": "541158399",
            "country_code": "US",
            "telephone_number": "920-496-4700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEVINE",
        "first_name": "ELIZABETH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-19",
        "last_updated": "2018-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WI",
            "license": "240659",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "830633",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Green Bay, WI

Sources for this page

Verify at the official NPI Registry.