Individual provider Active NPI

Ashley Weiland

  • Family Nurse Practitioner
  • Mount Pleasant, WI
National Provider Identifier
1841842697
Registry record updated Jul 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11056 Issued in WI
Practice address
8400 Washington Ave BLDG Suite304
Mount Pleasant, WI 53406-3735
Phone
(262) 631-8750
NPI assigned
Jul 11, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 29, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 220728 WI
Family Nurse Practitioner 363LF0000X 11056 WI Primary

Addresses

Primary practice location

8400 Washington Ave BLDG Suite304
Mount Pleasant, WI 53406-3735

Mailing address

W208S8861 Hillendale Dr
Muskego, WI 53150-8415

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
I20210724000074 WI Practitioner - Nurse Practitioner 6800299124 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11056WIMDProfessional Counselor
220728WIMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Impact Physician Group, Wisconsin LLC CurrentSince Sep 1, 2022 Accepting new patients
Phoenixc Healthcare, SC CurrentSince Jul 1, 2020 Accepting new patients
Impact Physician Group, LLC Past Accepting new patients
Bruce a Luccas, MD, LLC PastSince Jul 1, 2020 Accepting new patients

Locations

6121 Green Bay Rd
Ste 100
Kenosha, WI 53142
Phone (262) 945-7557

3200 S 103rd St
Milwaukee, WI 53227
Phone (414) 440-0500

Interoperability endpoints

  • Direct secure messaging: aweiland191935@aurora.direct-ci.com

Organizations & group practices 4

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1562803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659052800000",
    "number": "1841842697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "W208S8861 HILLENDALE DR",
            "city": "MUSKEGO",
            "state": "WI",
            "postal_code": "531508415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8400 WASHINGTON AVE BLDG SUITE304",
            "city": "MOUNT PLEASANT",
            "state": "WI",
            "postal_code": "534063735",
            "telephone_number": "262-631-8750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEILAND",
        "first_name": "ASHLEY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-07-11",
        "last_updated": "2022-07-29",
        "certification_date": "2022-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WI",
            "license": "220728",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "11056",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Pleasant, WI

Sources for this page

Verify at the official NPI Registry.