NPIMap

Individual provider Active NPI

Elizabeth Nicole Borchardt, APNP

  • Nurse Practitioner
  • Tigerton, WI
National Provider Identifier
1821556424
Registry record updated Oct 28, 2021
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Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
9112-33 Issued in WI
Practice address
110 Cedar St
Tigerton, WI 54486-9527
Phone
(715) 535-2115
NPI assigned
Mar 4, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 9112-33 WI Primary

Addresses

Primary practice location

110 Cedar St
Tigerton, WI 54486-9527

Mailing address

3 Neenah Ctr
Neenah, WI 54956-3070
Phone (715) 535-2115

Other practice location 1

5412 US Highway 10 E
Stevens Point, WI 54482-8559
Phone (715) 346-5243

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190515001856 WI Practitioner - Nurse Practitioner 4880937838 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Thedacare, IncorporatedGroup PAC ID 1759294887, 654 clinicians

Practice addresses (Care Compare)

110 Cedar St
Tigerton, WI 54486-9527
Phone (715) 535-2115

Hospital & facility affiliations

  • Thedacare Regional Med Ctr - Neenah Hospital, Neenah, WI, CCN 520045
  • Thedacare Medical Center - Shawano Hospital, Shawano, WI, CCN 521346

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9112-33WIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ascension Medical Group-Fox Valley Wisconsin, Inc CurrentSince Sep 18, 2020 Accepting new patients
Thedacare, Incorporated CurrentSince Oct 1, 2021 Accepting new patients
Thedacare Medical Center - Shawano, Inc. CurrentSince Oct 1, 2021 Accepting new patients
Ascension Medical Group-Fox Valley Wisconsin, Inc CurrentSince Sep 18, 2020 Accepting new patients
Signify Health Medical Associates, PLLC Nurse Practitioner CurrentSince Jun 1, 2021 Accepting new patients
Thedacare Medical Center - Shawano, Inc. CurrentSince Oct 1, 2021 Accepting new patients
Thedacare Medical Center - Berlin, Inc. Past Accepting new patients

Locations

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

4480 W Spencer St
Appleton, WI 54914
Phone (920) 738-4800

1501 S Madison St
Appleton, WI 54915
Phone (920) 730-4435

811 E Washington Ave
Madison, WI 53703
Phone (469) 466-7420

3 Neenah Ctr
Neenah, WI 54956
Phone (920) 454-4229

2700 W 9th Ave
Oshkosh, WI 54904
Phone (920) 223-0220

100 Cty Road B
Shawano, WI 54166
Phone (715) 524-2161

Interoperability endpoints

  • Direct secure messaging: eborchardt316577@direct.thedacare.org

Organizations & group practices 18

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.

View all 18

Hospital & facility affiliations 6

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": "1551657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635379200000",
    "number": "1821556424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 NEENAH CTR",
            "city": "NEENAH",
            "state": "WI",
            "postal_code": "549563070",
            "telephone_number": "715-535-2115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 CEDAR ST",
            "city": "TIGERTON",
            "state": "WI",
            "postal_code": "544869527",
            "telephone_number": "715-535-2115"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5412 US Highway 10 E",
            "address_purpose": "LOCATION",
            "city": "Stevens Point",
            "state": "WI",
            "postal_code": "544828559",
            "country_code": "US",
            "telephone_number": "715-346-5243",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BORCHARDT",
        "first_name": "ELIZABETH",
        "middle_name": "NICOLE",
        "name_prefix": "Mrs.",
        "credential": "APNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-04",
        "last_updated": "2021-10-28",
        "certification_date": "2021-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "9112-33",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tigerton, WI

Sources for this page

Verify at the official NPI Registry.