Individual provider Active NPI

Carla Mae Weismantel, APNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Milwaukee, WI
National Provider Identifier
1760111256
Registry record updated Jan 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
14817-33 Issued in WI
Practice address
5007 S Howell Ave Ste 350
Milwaukee, WI 53207-6159
Phone
(262) 789-1191
NPI assigned
Jun 9, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Registered Nurse 163WP0808X 1155040 KY
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 14817-33 WI Primary

Addresses

Primary practice location

5007 S Howell Ave Ste 350
Milwaukee, WI 53207-6159

Mailing address

665 Winding Woods Dr
Loveland, OH 45140-8080
Phone (513) 490-6485

Other practice location 1

7200 Wyoming Springs Dr Ste 1600
Round Rock, TX 78681-4307
Phone (737) 225-6989

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
I20240503002706 WI Practitioner - Nurse Practitioner 0143605949 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Rockford Psychiatric Medical Services SCGroup PAC ID 6901089515, 154 clinicians

Practice addresses (Care Compare)

1233 N Mayfair Rd
Suite 207
Wauwatosa, WI 53226-3255
Phone (414) 296-6189

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1155040KYMDPsychiatric/Mental Health Registered Nurse
14817-33WIMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Rockford Psychiatric Medical Services, S.C. CurrentSince Jun 1, 2024 Accepting new patients

Locations

1211 W 22nd St
Ste 406
Oak Brook, IL 60523

780 Regent St
Ste 309
Madison, WI 53715
Phone (608) 690-5657

9000 W Chester St
Ste 100
Milwaukee, WI 53214
Phone (414) 296-6189

1233 N Mayfair Rd
Ste 207
Wauwatosa, WI 53226
Phone (414) 285-6018

Interoperability endpoints

  • Direct secure messaging: carla.weismantel.1@25899.direct.athenahealth.com

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 and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1654732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704672000000",
    "number": "1760111256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "665 WINDING WOODS DR",
            "city": "LOVELAND",
            "state": "OH",
            "postal_code": "451408080",
            "telephone_number": "513-490-6485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5007 S HOWELL AVE STE 350",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532076159",
            "telephone_number": "262-789-1191"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7200 Wyoming Springs Dr Ste 1600",
            "address_purpose": "LOCATION",
            "city": "Round Rock",
            "state": "TX",
            "postal_code": "786814307",
            "country_code": "US",
            "telephone_number": "737-225-6989",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WEISMANTEL",
        "first_name": "CARLA",
        "middle_name": "MAE",
        "credential": "APNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-09",
        "last_updated": "2024-01-08",
        "certification_date": "2024-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "KY",
            "license": "1155040",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WI",
            "license": "14817-33",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.