Individual provider Active NPI

Kelly Woppert

  • Family Nurse Practitioner
  • Sussex, WI
National Provider Identifier
1760856546
Registry record updated Oct 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
6722-33 Issued in WI
Practice address
N66W25201 County Highway VV
Fastcare
Sussex, WI 53089-2677
Phone
(262) 532-8690
NPI assigned
Nov 17, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 6722-33 WI Primary

Addresses

Primary practice location

N66W25201 County Highway VV
Fastcare
Sussex, WI 53089-2677

Mailing address

N51 W24953 Lisbon Road
Fastcare
Sussex, WI 53089-2677
Phone (262) 532-8690

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
I20160120002522 WI Practitioner - Nurse Practitioner 9335442656 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

N51 W24953 Lisbon Rd
Sussex, WI 53089
Phone (262) 532-8691

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Froedtert &the Medical College of Wisconsin Community Physicians, Inc. CurrentSince Feb 16, 2016 Accepting new patients
Froedtert &the Medical College of Wisconsin Community Physicians, Inc. CurrentSince Feb 16, 2016 Accepting new patients
The Medical College of Wisconsin, Inc. Current Accepting new patients

Locations

W168N11237 Western Ave
Germantown, WI 53022
Phone (262) 253-5060

110 Lone Oak Ln
Hartford, WI 53027
Phone (262) 670-1800

4805 S Moorland Rd
New Berlin, WI 53151
Phone (262) 798-7200

N51W24953 Lisbon Rd
Pewaukee, WI 53072
Phone (262) 532-8691

N66W25201 Silver Spring Dr
Sussex, WI 53089
Phone (262) 532-8691

N64W24801 Main St
Sussex, WI 53089
Phone (262) 246-3000

1155 N Mayfair Rd
Wauwatosa, WI 53226
Phone (414) 955-5990

Organizations & group practices 3

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.

Hospital & facility affiliations 1

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": "1447718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475798400000",
    "number": "1760856546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "N51 W24953 LISBON ROAD",
            "address_2": "FASTCARE",
            "city": "SUSSEX",
            "state": "WI",
            "postal_code": "530892677",
            "telephone_number": "262-532-8690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "N66W25201 COUNTY HIGHWAY VV",
            "address_2": "FASTCARE",
            "city": "SUSSEX",
            "state": "WI",
            "postal_code": "530892677",
            "telephone_number": "262-532-8690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOPPERT",
        "first_name": "KELLY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-11-17",
        "last_updated": "2016-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "6722-33",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sussex, WI

Sources for this page

Verify at the official NPI Registry.