Individual provider Active NPI

Nancy Ryan, APNP

  • Family Nurse Practitioner
  • Johnson Creek, WI
National Provider Identifier
1780752832
Registry record updated Jan 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
629033 Issued in WI
Practice address
1225 Remmel Dr
Johnson Creek, WI 53094-8511
Phone
(920) 674-6255
Fax
(920) 674-5288
NPI assigned
Nov 30, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2021

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 629033 WI Primary

Addresses

Primary practice location

1225 Remmel Dr
Johnson Creek, WI 53094-8511

Mailing address

147 W Rockwell St
Jefferson, WI 53549-2048
Phone (920) 674-6255

Other practice location 1

147 W Rockwell St
Jefferson, WI 53549-2048
Phone (920) 674-6255

Other identifiers 1

IdentifierTypeStateIssuer
43855500MedicaidWI

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address nryan1123474@direct.uwhealth.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
629033WIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Rainbow Hospice Care, Inc. Family CurrentSince Mar 19, 2023 Accepting new patients
Watertown Family Practice Associates S.C. Current Accepting new patients

Locations

147 W Rockwell St
Jefferson, WI 53549
Phone (920) 674-6255

127 Hospital Dr
Watertown, WI 53098
Phone (414) 261-8500

1225 Remmel Dr
Watertown, WI 53094
Phone (920) 674-6255

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/20962/brand/1/csg/1/fhir/r4
  • Direct secure messaging: nancy.ryan@rainbowhospicecare.cernerdirect.com

Organizations & group practices 2

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": "1164844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609718400000",
    "number": "1780752832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "147 W ROCKWELL ST",
            "city": "JEFFERSON",
            "state": "WI",
            "postal_code": "535492048",
            "telephone_number": "920-674-6255",
            "fax_number": "920-674-5288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 REMMEL DR",
            "city": "JOHNSON CREEK",
            "state": "WI",
            "postal_code": "530948511",
            "telephone_number": "920-674-6255",
            "fax_number": "920-674-5288"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "147 W Rockwell St",
            "address_purpose": "LOCATION",
            "city": "Jefferson",
            "state": "WI",
            "postal_code": "535492048",
            "country_code": "US",
            "telephone_number": "920-674-6255",
            "fax_number": "920-674-5288",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RYAN",
        "first_name": "NANCY",
        "credential": "APNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-30",
        "last_updated": "2021-01-04",
        "certification_date": "2021-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "629033",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "43855500",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nryan1123474@direct.uwhealth.org",
            "affiliation": "N",
            "address_1": "5395 E Cheryl Pkwy",
            "city": "Fitchburg",
            "state": "WI",
            "country_code": "US",
            "postal_code": "537115395",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Johnson Creek, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.