NPIMap

Individual provider Active NPI

Maxine Lynn Paquet

  • Family Nurse Practitioner
  • Ashland, WI
National Provider Identifier
1841223252
Registry record updated May 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2484-033 Issued in WI
Practice address
1615 Maple LN Ste 1
Ashland, WI 54806-3610
Phone
(715) 685-7500
Fax
(715) 682-2481
NPI assigned
Jul 9, 2006
Last updated
May 23, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 23, 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 2484-033 WI Primary

Addresses

Primary practice location

1615 Maple LN Ste 1
Ashland, WI 54806-3610

Mailing address

1615 Maple LN Ste 1
Ashland, WI 54806-3610
Phone (715) 685-7500

Other identifiers 2

IdentifierTypeStateIssuer
41263100MedicaidWI
886416100MedicaidMN

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
I20050616000494 WI Practitioner - Nurse Practitioner 1658315056 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Duluth Clinic LTDGroup PAC ID 2567374283, 1,135 clinicians

Practice addresses (Care Compare)

15495 County Rd B
Hayward, WI 54843-3438
Phone (715) 634-2641

1615 Maple LN
Suite 1
Ashland, WI 54806-3630
Phone (715) 685-7500

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2484-033WIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St. Mary's Hospital of Superior CurrentSince Jan 1, 2017 Accepting new patients
St. Mary's Duluth Clinic Health System Current Accepting new patients
The Duluth Clinic, LTD. CurrentSince Jun 1, 2005 Accepting new patients
The Duluth Clinic, LTD Current Accepting new patients
St. Mary's Hospital of Superior CurrentSince Jan 1, 2017 Accepting new patients
The Duluth Clinic, LTD Past Accepting new patients
Essentia Health Virginia LLC Past Accepting new patients

Locations

400 E 3rd St
Duluth, MN 55805
Phone (218) 722-8364

1615 Maple Ln
Ste 1
Ashland, WI 54806
Phone (715) 685-7500

11134 N State Road 77
Hayward, WI 54843
Phone (715) 634-5505

15495 County Road B
Hayward, WI 54843
Phone (715) 634-2641

707 Ash St
Spooner, WI 54801
Phone (715) 635-2151

3500 Tower Ave
Superior, WI 54880
Phone (715) 392-8281

3500 Tower Ave
Ste 1
Superior, WI 54880
Phone (715) 395-5457

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 12

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": "1152403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463961600000",
    "number": "1841223252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1615 MAPLE LN STE 1",
            "city": "ASHLAND",
            "state": "WI",
            "postal_code": "548063610",
            "telephone_number": "715-685-7500",
            "fax_number": "715-682-2481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1615 MAPLE LN STE 1",
            "city": "ASHLAND",
            "state": "WI",
            "postal_code": "548063610",
            "telephone_number": "715-685-7500",
            "fax_number": "715-682-2481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAQUET",
        "first_name": "MAXINE",
        "middle_name": "LYNN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-09",
        "last_updated": "2016-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "2484-033",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41263100",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "886416100",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ashland, WI

Sources for this page

Verify at the official NPI Registry.