Individual provider Active NPI

Nicole Pullin, NP

  • Nurse Practitioner
  • Marinette, WI
National Provider Identifier
1790046118
Registry record updated Sep 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
4870 Issued in WI
Practice address
3003 University Dr
Marinette, WI 54143-4110
Phone
(715) 735-4200
NPI assigned
Jun 1, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 4870-33 WI
Nurse Practitioner 363L00000X 4870 WI Primary

Addresses

Primary practice location

3003 University Dr
Marinette, WI 54143-4110

Mailing address

PO Box 735044
Chicago, IL 60673-5044
Phone (715) 735-4200

Other practice location 1

700 S Park St
Madison, WI 53715-1830
Phone (608) 251-6100

Other identifiers 1

IdentifierTypeStateIssuer
100024191MedicaidWI

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
I20120817000060 WI Practitioner - Nurse Practitioner 1658527080 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aurora Medical Group, Inc.Group PAC ID 6709794258, 3,764 clinicians

Practice addresses (Care Compare)

3003 University Dr
Marinette, WI 54143-4110
Phone (715) 735-6621

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4870WIMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Aurora Medical Group, Inc. CurrentSince Oct 9, 2023 Accepting new patients
Reedsburg Area Medical Center, Inc. CurrentSince Mar 3, 2018 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Oct 9, 2023 Accepting new patients
Reedsburg Area Medical Center Inc CurrentSince Mar 3, 2018 Accepting new patients
Madison Emergency Physicians, SC CurrentSince Jun 13, 2012 Accepting new patients
Aurora Medical Group, Inc. Current Accepting new patients

Locations

3400 E Racine St
Janesville, WI 53546
Phone (608) 373-8000

700 S Park St
Madison, WI 53715
Phone (608) 260-2900

3003 University Dr
Marinette, WI 54143
Phone (715) 735-4200

Bin 88276
Milwaukee, WI 53288

1020 N 12th St
Milwaukee, WI 53233
Phone (414) 219-3056

2000 N Dewey Ave
Reedsburg, WI 53959
Phone (608) 524-6487

530 Wisconsin Dells Pkwy S
Wisconsin Dells, WI 53965
Phone (608) 253-8515

Interoperability endpoints

  • Direct secure messaging: npullin382122@direct.myadvocateaurora.org

Organizations & group practices 6

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 3

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": "1338508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695513600000",
    "number": "1790046118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 735044",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606735044",
            "telephone_number": "715-735-4200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3003 UNIVERSITY DR",
            "city": "MARINETTE",
            "state": "WI",
            "postal_code": "541434110",
            "telephone_number": "715-735-4200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "700 S Park St",
            "address_purpose": "LOCATION",
            "city": "Madison",
            "state": "WI",
            "postal_code": "537151830",
            "country_code": "US",
            "telephone_number": "608-251-6100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PULLIN",
        "first_name": "NICOLE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-01",
        "last_updated": "2023-09-24",
        "certification_date": "2023-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "4870-33",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "4870",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100024191",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marinette, WI

Sources for this page

Verify at the official NPI Registry.